Ayyala R S, Stevens S X, Grizzard W S, Fouraker B D
University of South Florida Eye Institute, Tampa 33612-4799, USA.
Cornea. 1998 Mar;17(2):233-5. doi: 10.1097/00003226-199803000-00022.
To present a case of recurrent postoperative endophthalmitis with a scleral-tunnel abscess and adjacent microbial keratitis.
A 76-year-old woman with microbial keratitis and recurrent endophthalmitis after cataract surgery was referred to a tertiary care center for further management. The medical chart of the patient was reviewed.
The patient was seen on the eighth postoperative day with endophthalmitis that responded to medical treatment. Initial vitreous cultures were negative. The endophthalmitis recurred after the medical treatment was discontinued. She subsequently developed microbial keratitis at 1 o'clock adjacent to the limbus. Cultures from the site of corneal abscess and vitreous grew coagulase-negative Staphylococcus. Gonioscopy revealed the presence of a scleral abscess, which responded to subconjunctival injection of vancomycin and an intense and prolonged course of topical antibiotics.
A scleral abscess should be suspected in a patient with endophthalmitis or microbial keratitis or both after a scleral-tunnel incision for cataract surgery.
报告一例白内障手术后复发性眼内炎合并巩膜隧道脓肿及邻近微生物性角膜炎的病例。
一名76岁女性在白内障手术后发生微生物性角膜炎和复发性眼内炎，被转诊至三级医疗中心进行进一步治疗。查阅了该患者的病历。
患者术后第8天因眼内炎就诊，经药物治疗后病情好转。最初的玻璃体培养结果为阴性。停药后眼内炎复发。随后，她在角膜缘1点处发生了微生物性角膜炎。角膜脓肿部位和玻璃体的培养物培养出凝固酶阴性葡萄球菌。前房角镜检查发现存在巩膜脓肿，经结膜下注射万古霉素及强化和长期局部应用抗生素治疗后，病情好转。
白内障手术巩膜隧道切口后发生眼内炎或微生物性角膜炎或两者兼有的患者，应怀疑存在巩膜脓肿。
