Journal of Nippon Medical School: Vol.71 No.5 page.340

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ArticleTitle Post-cataract Surgery Endophthalmitis Treated with Core Vitrectomy: A Case Report

AuthorList Toshihiko Shiwa¹, Katsuya Umeno², Yuji Hara³ and Fumiaki Yoshitomi⁴

Affiliation ¹Department of Ophthalmology, Nippon Medical School
²Umeno Eye Clinic, ³Hanami Eye Center
⁴Dazaifu Yoshitomi Eye Center

Language EN

Volume 71

Issue 5

Year 2004

Page 340-344

Received June 9, 2004

Accepted July 7, 2004

Keywords cataract surgery, endophthalmitis, core vitrectomy

Abstract Postoperative endophthalmitis is one of the most serious complications after cataract surgery though its frequency may be low. We report a case with post-cataract extraction bacterial endophthalmitis treated favorably by core vitrectomy through pars plana with anterior vitrectomy cutter (A-vit).
The patient, a 72-year-old woman, presented with blurred vision 7 days after phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. Her initial visual acuity was counting fingers. As hypopyon and corneal edema progressed in a few hours, we decided to perform vitectomy. Firstly, we performed IOL explantation and anterior vitrectomy through the corneal stab incision with A-vit attached to the phaco machine. The inflammation, however, appeared to be severe. Secondly we performed core vitrectomy with the same cutter as we used in the first operation through pars plana as well as intravitreal injection of vancomycin on the following day. The inflammation was gradually subsided and her corrected visual acuity was recovered to 30/20 at 7 months after the vitrectomy.
The results is suggest that for cataract surgeons in the facilities that are not equipped with 3-port vitrectomy machine, post-cataract extraction bacterial endophthalmitis of the emergency stage can be successfully treated by core vitrectomy through pars plana as well as intravitreal injection of antibiotics with neither vitreous shaving at the vitreous base nor artificial posterior vitreous detachment.

Correspondence to Toshihiko Shiwa, MD, Department of Ophthalmology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
tshiwa@nms.ac.jp

ArticleTitle	Post-cataract Surgery Endophthalmitis Treated with Core Vitrectomy: A Case Report
AuthorList	Toshihiko Shiwa¹, Katsuya Umeno², Yuji Hara³ and Fumiaki Yoshitomi⁴
Affiliation	¹Department of Ophthalmology, Nippon Medical School ²Umeno Eye Clinic, ³Hanami Eye Center ⁴Dazaifu Yoshitomi Eye Center
Language	EN
Volume	71
Issue	5
Year	2004
Page	340-344
Received	June 9, 2004
Accepted	July 7, 2004
Keywords	cataract surgery, endophthalmitis, core vitrectomy
Abstract	Postoperative endophthalmitis is one of the most serious complications after cataract surgery though its frequency may be low. We report a case with post-cataract extraction bacterial endophthalmitis treated favorably by core vitrectomy through pars plana with anterior vitrectomy cutter (A-vit). The patient, a 72-year-old woman, presented with blurred vision 7 days after phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. Her initial visual acuity was counting fingers. As hypopyon and corneal edema progressed in a few hours, we decided to perform vitectomy. Firstly, we performed IOL explantation and anterior vitrectomy through the corneal stab incision with A-vit attached to the phaco machine. The inflammation, however, appeared to be severe. Secondly we performed core vitrectomy with the same cutter as we used in the first operation through pars plana as well as intravitreal injection of vancomycin on the following day. The inflammation was gradually subsided and her corrected visual acuity was recovered to 30/20 at 7 months after the vitrectomy. The results is suggest that for cataract surgeons in the facilities that are not equipped with 3-port vitrectomy machine, post-cataract extraction bacterial endophthalmitis of the emergency stage can be successfully treated by core vitrectomy through pars plana as well as intravitreal injection of antibiotics with neither vitreous shaving at the vitreous base nor artificial posterior vitreous detachment.
Correspondence to	Toshihiko Shiwa, MD, Department of Ophthalmology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan tshiwa@nms.ac.jp