Phacoantigenic Reaction Masquerading as Postoperative Endophthalmitis in a Silicone Oil-filled Eye

A 72-year-old phakic male with immature cataract underwent vitrectomy with silicone oil injection in his left eye for rhegmatogenous retinal detachment. The surgery was uneventful except for lens touch during vitrectomy. Two weeks postoperatively, he presented with circumcorneal congestion, hypopyon, and absent fundal glow suggestive of postoperative endophthalmitis. The patient was managed conservatively as he refused further intervention. Five weeks later, ocular inflammation subsided following posterior dislocation of the cataractous lens, thus revealing the error in our initial diagnosis. Following surgical intervention, the inflammation gradually settled. However, the eye progressed to the prephthisical stage. Phacoantigenic reaction following lens touch during vitreoretinal surgery is very rare. Hence, surgeons should maintain a high index of suspicion in similar case, and prompt intervention is warranted to prevent further complications.