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Chronic postoperative endophthalmitis associated with Propionibacterium acnes
Archives of Ophthalmology (Chicago, Ill. : 1960)
|September 1, 1987
Summary
Propionibacterium acnes can cause delayed, chronic endophthalmitis after cataract surgery. Complete capsulectomy may be needed for persistent inflammation, highlighting the need for microbial testing in delayed postsurgical cases.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Cataract surgery, specifically extracapsular cataract extraction with posterior chamber intraocular lens implantation, can be complicated by intraocular inflammation.
- Delayed-onset endophthalmitis is a challenging postsurgical complication.
Observation:
- Two cases of Propionibacterium acnes endophthalmitis are presented.
- The clinical, microbiologic, and histopathologic features suggest sequestration of the organism within the capsular bag.
Findings:
- Propionibacterium acnes is associated with delayed-onset, chronic, and indolent intraocular inflammation following cataract surgery.
- Diagnosis can be difficult due to organism sequestration in the capsular bag.
Implications:
- Complete capsulectomy may be necessary for persistent inflammation unresponsive to conventional treatments like pars plana vitrectomy, partial capsulectomy, and antibiotics.
- Microbiologic investigation is crucial for all postsurgical inflammation, even with delayed onset, to differentiate from sterile postoperative uveitis.