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Post-keratoplasty endophthalmitis caused by Proteus mirabilis
1Department of Ophthalmology & Visual Sciences, Chinese University of Hong Kong, Prince of Wales Hospital Shatin, N. T., Hong Kong. dennislam@cuhk.edu.hk
Eye (London, England)
|June 6, 1998
Summary
A rare case of endophthalmitis caused by Proteus mirabilis following corneal transplant was successfully treated. This study highlights the importance of donor cornea screening and advanced storage media in preventing post-keratoplasty infections.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Corneal transplantation is a common procedure for vision restoration.
- Endophthalmitis is a severe intraocular infection that can lead to vision loss.
- Proteus mirabilis is a bacterium rarely implicated in post-keratoplasty endophthalmitis.
Observation:
- A diabetic patient developed endophthalmitis due to Proteus mirabilis after a triple procedure including penetrating keratoplasty.
- The infecting organism was resistant to gentamicin, the antibiotic in the donor cornea's storage medium.
- The donor cornea was imported from Sri Lanka.
Findings:
- An aggressive treatment regimen including topical, systemic, and intravitreal antibiotics was initiated.
- Surgical intervention involved corneal graft exchange and pars plana vitrectomy.
- The patient experienced a rapid recovery with a final visual outcome of 20/40.
Implications:
- This is the first reported case of post-keratoplasty endophthalmitis caused by Proteus mirabilis.
- The findings underscore the need for rigorous donor cornea screening and antibiotic susceptibility testing.
- Advanced storage media like Optisol GS may play a role in preventing such sight-threatening infections.