Acute-onset postoperative endophthalmitis after cataract surgery and transzonular intravitreal triamcinolone-moxifloxacin

J Cataract Refract Surg. 2018 Dec;44(12):1436-1440. doi: 10.1016/j.jcrs.2018.07.055. Epub 2018 Sep 18.

Abstract

Purpose: To report 4 cases of acute postoperative endophthalmitis (POE) after uneventful temporal clear corneal topical dropless cataract surgery involving intravitreal triamcinolone-moxifloxacin (TriMoxi).

Setting: Private practice in Peoria, IL, USA.

Design: Retrospective noncomparative case series.

Methods: Charts of patients presenting with POE after an uneventful temporal clear corneal phacoemulsification with in-the-bag implantation of a posterior chamber intraocular lens over a 15-month period were reviewed.

Results: Patients presented with typical signs and symptoms of acute POE 3 to 14 days after cataract surgery. The POE resolved after 25-gauge pars plana vitrectomy and injection of intravitreal vancomycin, ceftazidime, and dexamethasone. Two of 4 eyes were culture-positive for coagulase-negative Staphylococcus. The corrected distance visual acuity at the last follow-up visit was 20/40 or better in 3 eyes, and 20/400 in 1 eye because of underlying atrophic age-related macular degeneration.

Conclusion: Postoperative endophthalmitis can occur after dropless cataract surgery with intravitreal triamcinolone-moxifloxacin.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects
  • Drug Combinations
  • Endophthalmitis / diagnosis
  • Endophthalmitis / etiology*
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / etiology*
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects
  • Humans
  • Intravitreal Injections / adverse effects
  • Male
  • Moxifloxacin / administration & dosage
  • Moxifloxacin / adverse effects*
  • Phacoemulsification / adverse effects*
  • Retrospective Studies
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / etiology*
  • Triamcinolone / administration & dosage
  • Triamcinolone / adverse effects*

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • Glucocorticoids
  • Triamcinolone
  • Moxifloxacin