Granulicatella adiacens endophthalmitis after phacoemulsification cataract surgery

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Granulicatella adiacens is a rare cause of postoperative endophthalmitis.
• Endophthalmitis following phacoemulsification surgery can lead to significant vision impairment.

Purpose of the Study:

• To report two cases of acute endophthalmitis caused by Granulicatella adiacens after phacoemulsification.
• To describe the clinical presentation, diagnostic methods, and treatment outcomes.
• To evaluate the role of pan-retinal photocoagulation in managing ischemic retinal complications.

Main Methods:

• Case report of two patients with endophthalmitis post-phacoemulsification.
• Vitreous biopsy with genome sequencing for pathogen identification.
• Intraoperative findings documented.
• Treatment included intravitreal antibiotics and pan-retinal photocoagulation.
• Postoperative management of rhegmatogenous retinal detachment.

Main Results:

• Granulicatella adiacens identified as the causative agent in both cases.
• Severe intraocular inflammation, vitritis, retinal hemorrhages, vascular occlusion, and necrosis observed.
• Pan-retinal photocoagulation performed due to ischemic retinal appearance.
• Both patients developed rhegmatogenous retinal detachment, successfully treated.
• Visual acuity improved post-treatment.
• Novel findings of hyperreflective dots and Henle fiber layer hemorrhage in endophthalmitis.

Conclusions:

• Granulicatella adiacens endophthalmitis is a serious complication of cataract surgery.
• Genome sequencing is valuable for diagnosing rare pathogens.
• Intraoperative pan-retinal photocoagulation may be beneficial in ischemic cases to prevent rubeosis and reduce the risk/extent of retinal detachment.