Related Experiment Videos
Endophthalmitis due to Propionibacterium acnes sequestered between IOL optic and posterior capsule
M R Sawusch1, R G Michels, W J Stark
1Wilmer Ophthalmological Institute, Baltimore, MD.
Ophthalmic Surgery
|February 1, 1989
Summary
Propionibacterium acnes caused delayed uveitis after cataract surgery. Bacteria were found within the capsular bag, requiring specific diagnosis and treatment for this persistent endophthalmitis.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Cataract surgery, specifically extracapsular extraction with intraocular lens (IOL) implantation, is a common procedure.
- Delayed onset uveitis can occur post-operatively, presenting a diagnostic challenge.
Observation:
- A 68-year-old woman developed persistent uveitis weeks after routine cataract surgery.
- Initial steroid treatment was partially effective, but a capsular plaque suggested an infectious etiology.
- Cultures from vitrectomy and capsular biopsy were positive for Propionibacterium acnes after a nine-day incubation period.
Findings:
- Propionibacterium acnes was identified as the causative agent of the delayed endophthalmitis.
- Bacteria were visualized within the capsular bag using light and electron microscopy.
- The intraocular lens was retained in situ despite the infection.
Implications:
- This case highlights the importance of considering Propionibacterium acnes in delayed post-cataract surgery endophthalmitis.
- Prompt microbiological diagnosis is crucial for effective treatment of persistent uveitis.
- Understanding bacterial sequestration within the capsular bag may inform future surgical and prophylactic strategies.