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Periocular infection after strabismus surgery. The Periocular Infection Study Group

J D Kivlin1, M E Wilson

  • 1Department of Ophthalmology, Pediatric Ophthalmology, Strabismus, and Genetics, Medical College of Wisconsin, Milwaukee, USA.

Journal of Pediatric Ophthalmology and Strabismus
|January 1, 1995
PubMed
Summary

Periocular infections like cellulitis after extraocular muscle surgery are rare but serious. Staphylococcus aureus is a common cause, and prompt, often intravenous, antibiotic treatment is crucial for resolution.

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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Infectious Diseases

Background:

  • Cellulitis and subconjunctival abscess are rare but serious complications following extraocular muscle surgery.
  • Detailed reports on these post-operative infections are limited, necessitating further investigation.

Purpose of the Study:

  • To survey members of the American Association for Pediatric Ophthalmology and Strabismus (AAPO&S) regarding cases of cellulitis and subconjunctival abscess after extraocular muscle surgery.
  • To analyze contributed cases to provide greater information on this serious complication.

Main Methods:

  • A survey was distributed to members of the AAPO&S.
  • Contributed cases of cellulitis and subconjunctival abscess were analyzed.

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Main Results:

  • Twenty-five cases of cellulitis were analyzed, with a predominance of preschool-aged patients.
  • Staphylococcus aureus was the most common organism cultured.
  • Marked swelling and pain were the most common presenting symptoms, often appearing after a normal initial postoperative visit.
  • Predisposing factors included sinusitis, eye rubbing, and poor hygiene.
  • Two patients had bacteremia; none developed endophthalmitis.
  • All cases resolved with antibiotics, but only five were successfully treated with oral antibiotics alone.

Conclusions:

  • Periocular infections after extraocular muscle surgery can occur even after a normal initial postoperative visit.
  • Marked swelling and pain warrant closer inspection for infection.
  • Staphylococcus aureus is a frequent pathogen, and treatment with oral antibiotics alone may be insufficient.