Susan Ruyu Qi1,2*, Mélanie Hébert1,2, Mike Yuan Chen3, Steve A Arshinoff3,4 and Eric Tourville1,2
1Department of Ophthalmology, Hôpital du Saint-Sacrement, Quebec City, Canada
2Faculty of Medicine, Université Laval, Quebec City, Canada
3York Finch Eye Associates, Toronto, Ontario, Canada
4Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
*Corresponding Author: Susan Ruyu Qi, Department of Ophthalmology, Hôpital du Saint-Sacrement, Quebec City, Canada.
Received: March 01, 2022; Published: March 25, 2022
Introduction: Bilateral simultaneous postoperative endophthalmitis (BSPOE) is a rare but potentially devastating complication following immediately sequential bilateral cataract surgery (ISBCS). We present a case of BSPOE in an immunocompromised patient to suggest actionable precautions in this patient population.
Patient and clinical findings: A 79-year-old male with specific pneumococcal antibody deficiency underwent uneventful ISBCS with prophylactic intracameral 0.1 mL undiluted moxifloxacin 0.5%. The patient returned with decreased visual acuities of light perception in the right eye (OD) at 5 days and count fingers in the left eye (OS) at 7 days postoperatively with severe anterior chamber inflammation in each eye.
Diagnosis, Intervention, and Outcomes: The patient was diagnosed with BSPOE. Tap-and-inject was performed emergently on day 5 OD and day 7 OS with intravitreal vancomycin 1 mg/0.1 mL, dexamethasone 0.4 mg/0.1 mL, and ceftazidime 2.25 mg/0.1 mL. Cultures done OD were positive for methicillin-resistant coagulase-negative Staphylococcus epidermidis. The patient later underwent an anterior chamber washout, pars plana vitrectomy, and intravitreal injections of vancomycin 1 mg/0.1 mL and dexamethasone 0.04 mg/0.1 mL in both eyes (OU) and recovered 20/20 visual acuity OU at 6 weeks postoperatively.
Conclusions: This case raises critical issues about the adequacy of intracameral prophylaxis methods for immunosuppressed patients.
Keywords: Vancomycin; Bilateral Simultaneous Postoperative Endophthalmitis (BSPOE); Immediately Sequential Bilateral Cataract Surgery (ISBCS)
Citation: Susan Ruyu Qi., et al. “Bilateral Endophthalmitis After Immediately Sequential Bilateral Cataract Surgery (ISBCS) in an Immunodeficient Patient".Acta Scientific Ophthalmology 5.4 (2022): 73-76.
Copyright: © 2022 Susan Ruyu Qi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.