Propionibacterium Acnes Endophthalmitis Seven Months After Extracapsular Cataract Extraction and Intraocular Lens Implantation

Abstract

We present a case of endophthalmitis caused by Propionibacterium acnes seven months following extracapsular cataract extraction and intraocular lens implantation. The markedly delayed clinical course of endophthalmitis associated with this organism appears to be highly stereotypical. Recognition and treatment of this complication of cataract surgery allows an excellent chance at cure.

Chronic Inflammation After YAG Capsulotomy

“…Chronic endophthalmitis after cataract surgery can be challenging to diagnose and treat. Patients traditionally present with indolent low-grade inflammation from 6 weeks to several years after cataract surgery; thus, it is difficult to distinguish from a mild case of rebound iritis or a new case of granulomatous uveitis . Clues to the diagnosis include the delayed presentation along with the presence of keratic precipitates, beaded fibrin strands in the anterior chamber, vitritis, an intracapsular white plaque, and/or a hypopyon.…”

“…Patients traditionally present with indolent low-grade inflammation from 6 weeks to several years after cataract surgery; thus, it is difficult to distinguish from a mild case of rebound iritis or a new case of granulomatous uveitis. [1][2][3] Clues to the diagnosis include the delayed presentation along with the presence of keratic precipitates, beaded fibrin strands in the anterior chamber, vitritis, an intracapsular white plaque, and/or a hypopyon. Development of acute pain and inflammation after YAG capsulotomy may be attributable to liberation of organisms from the capsular plaque.…”