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Propionibacterium-associated endophthalmitis after extracapsular cataract extraction. Review of reported cases

D M Meisler1, S Mandelbaum

  • 1Department of Ophthalmology, Cleveland Clinic Foundation, OH 44106.

Ophthalmology
|January 1, 1989
PubMed

Insights

Propionibacterium endophthalmitis is a rare complication following cataract surgery. Early suspicion and appropriate diagnostic workup are crucial for managing this indolent intraocular inflammation.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Surgical Complications

Background:

  • Propionibacterium endophthalmitis is a significant complication after extracapsular cataract extraction (ECCE).
  • This condition often presents as a chronic, indolent intraocular inflammation, typically months after initial surgery.

Purpose of the Study:

  • To review cases of Propionibacterium-associated endophthalmitis following ECCE.
  • To discuss the clinical presentation, management, and outcomes of this specific type of endophthalmitis.

Main Methods:

  • Retrospective review of sixteen culture-proven cases of Propionibacterium endophthalmitis.
  • Analysis of clinical presentation, time of onset, treatment interventions, and visual acuity outcomes.

Main Results:

  • Inflammation occurred 2-10 months post-ECCE, sometimes after laser posterior capsulotomy.
  • Clinical signs included chronic iridocyclitis, keratic precipitates, hypopyon, and posterior capsule plaques.
  • Surgical intervention and intravitreal antibiotics were common; 11/16 patients achieved visual acuity of 20/40 or better.

Conclusions:

  • Propionibacterium endophthalmitis should be suspected in cases of chronic intraocular inflammation post-ECCE.
  • Prompt diagnosis via intraocular specimen culture and appropriate management, including surgical intervention and antibiotics, are vital for visual recovery.

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