Acta Scientific Ophthalmology (ISSN: 2582-3191)

Case Report Volume 5 Issue 4

Bilateral Endophthalmitis After Immediately Sequential Bilateral Cataract Surgery (ISBCS) in an Immunodeficient Patient

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

Abstract

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)

References

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  11. Lukewich MK., et al. “Incremental effect of topical and oral moxifloxacin administration with surgical intracameral prophylaxis”. Canadian Journal of Ophthalmology (2021).
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Citation

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

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.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

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