Choudhary Ayushi, Hande Prathiba, Gandhi Priyanka, Prabhu Vishma, Kathare Rupal, Chhablani Jay, Venkatesh Ramesh
Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India.
Department of Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, Pittsburg, PA, USA.
Eur J Ophthalmol. 2025 Mar;35(2):NP28-NP32. doi: 10.1177/11206721241300209. Epub 2024 Nov 15.
To report a rare case of acute bacterial endophthalmitis that developed after scleral buckling surgery performed with non-contact wide-angle viewing system (WAVS) and chandelier endoillumination.
A 63-year-old man underwent scleral buckling surgery using a WAVS with chandelier endoillumination for rhegmatogenous retinal detachment repair in his left eye. Seven days after the surgery, the patient noticed a marked decrease in his vision with ocular pain. No anterior chamber inflammation or exudates were found. No focal congestion or exudates were noted at the sclerotomy site. Posterior segment examination revealed severe vitreous haze and yellowish exudates in the vitreous cavity. Ocular ultrasound revealed dense vitritis, complete posterior vitreous separation, a fully attached retina, and a peripheral scleral buckle indent. Vitreous biopsy combined with pars plana vitrectomy with intravitreal antibiotic injections was done immediately, and was detected in the vitreous fluid. Following surgery, the inflammation and infection subsided and the visual acuity recovered to 6/9 in 6 weeks.
Infectious endophthalmitis is a rare occurrence after chandelier-assisted scleral buckling (SB) surgery, characterized by ocular pain and a sudden decline in vision as key symptoms. Clinicians should be cognizant of the possibility of its occurrence following SB surgery, especially when utilizing the WAVS with chandelier endoillumination.
报告1例罕见的急性细菌性眼内炎病例，该病例发生于使用非接触广角观察系统（WAVS）和吊灯式眼内照明进行巩膜扣带术后。
一名63岁男性因左眼孔源性视网膜脱离行巩膜扣带术，术中使用带吊灯式眼内照明的WAVS。术后7天，患者出现视力显著下降并伴有眼痛。眼前房未见炎症或渗出物。巩膜切开部位未见局部充血或渗出物。眼后段检查发现严重的玻璃体混浊和玻璃体内淡黄色渗出物。眼部超声显示浓密的玻璃体炎、完全性玻璃体后脱离、视网膜完全附着以及周边巩膜扣带压痕。立即进行了玻璃体活检并联合玻璃体切割术及玻璃体内注射抗生素，玻璃体液中检测到[未提及具体检测物]。术后，炎症和感染消退，6周时视力恢复到6/9。
吊灯辅助巩膜扣带（SB）术后感染性眼内炎罕见，主要症状为眼痛和视力突然下降。临床医生应认识到SB术后发生感染性眼内炎的可能性，尤其是在使用带吊灯式眼内照明的WAVS时。
