Alshahrani Saeed T, Arevalo J Fernando
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Ophthalmology Division, King Fahad Medical City, Riyadh, Saudi Arabia.
Case Rep Ophthalmol. 2020 Nov 9;11(3):595-599. doi: 10.1159/000510129. eCollection 2020 Sep-Dec.
A patient presented with complaints of a sudden decrease in vision, ocular redness, and pain in the right eye. The patient had a history of clear lens extraction with intraocular lens (IOL) implantation for myopia 2 years previously. He had been prescribed topical steroids for episodes of inflammation that occurred repeatedly every 1-2 months. With a presumptive diagnosis of chronic endophthalmitis, a 23-G transconjunctival sutureless pars plana vitrectomy (PPV) with delivery of intravitreal antibiotics was performed the next day. Culture sensitivity testing of the vitreous sample indicated that was sensitive to ceftazidime and gentamicin. Two weeks later, the patient presented with sudden loss of vision and all the signs of recurrent endophthalmitis. 23-G transconjunctival sutureless PPV was performed along with removal of the posterior chamber IOL through a corneal incision. Complete resolution was only achieved after removal of the IOL, resulting in excellent visual recovery. Due to its chronic and fulminating nature, can induce endophthalmitis and should be considered in the differential diagnosis. Aseptic measures are the best prevention.
一名患者因右眼视力突然下降、眼红和疼痛前来就诊。该患者2年前有因近视行透明晶状体摘除及人工晶状体(IOL)植入术史。他曾因每1 - 2个月反复发生的炎症发作而被开具局部类固醇药物。初步诊断为慢性眼内炎,次日进行了23G经结膜无缝线玻璃体切除术(PPV)并注入玻璃体内抗生素。玻璃体样本的培养药敏试验表明对头孢他啶和庆大霉素敏感。两周后,患者出现突然视力丧失及复发性眼内炎的所有体征。通过角膜切口进行了23G经结膜无缝线PPV并取出后房型IOL。仅在取出IOL后才实现完全缓解,视力恢复良好。由于其慢性和暴发性性质,可诱发眼内炎,应在鉴别诊断中予以考虑。无菌措施是最佳预防方法。