An intractable case of Pseudomonas aeruginosa infection after scleral buckling for rhegmatogenous retinal detachment

Abstract

BackgroundScleral buckling is still a common procedure to repair rhematogenous retinal detachment, and acute or chronic infection of the scleral explant is rare. We report an intractable case of acute scleral explant infection by Pseudomonas aeruginosa.CaseA 36-year-old man suffered from acute scleral explant infection by P. aeruginosa forty-eight hours after scleral buckling for rhegmatogenous retinal detachment. The infection was treated by intravenous administration of various appropriate antibiotics for eighteen days and washing the scleral explant with appropriate antibiotics, and appeared to be resolved. However, three months after the initial surgery, we had to remove the scleral explant because of recurrent infection.ObservationsWe encountered an intractable case of acute scleral explant infection by P. aeruginosa, that recurred and forced the removal of the scleral explant.ConclusionsWe found that recurrence of infection necessitated removal of the scleral explant, even though the organism was sensitive to the antibiotics used to treat the infection, and there was an appropriate duration of treatment. Early diagnosis and countermeasures, first considering conservative management, which may have a role in delaying buckle removal, and thus reduce the risk of retinal redetachment, and help prolong the time until surgical treatment such as removing the scleral explant is required.

Use of a subpalpebral lavage system as salvage therapy for Pseudomonas aeruginosa panophthalmitis due to an infected scleral buckle

“…1,2 In reports of P. aeruginosa -associated scleral buckle infection, persistent and recurrent infection have been noted, but none to the severity of panophthalmitis. 4,5 This case appears to be the first of P. aeruginosa scleral buckle biofilm leading to panophthalmitis.…”

“…1,2 In reports of P. aeruginosa-associated scleral buckle infection, persistent and recurrent infection have been noted, but none to the severity of panophthalmitis. 4,5 This case appears to be the first of P. aeruginosa scleral buckle biofilm leading to panophthalmitis. Pseudomonas aeruginosa ocular infections are associated with grave outcomes; eyes with P. aeruginosa endophthalmitis typically have a final visual acuity of hand motion or worse and 20-42% result in evisceration.…”

“…Pseudomonas aeruginosa ocular infections are associated with grave outcomes; eyes with P. aeruginosa endophthalmitis typically have a final visual acuity of hand motion or worse and 20-42% result in evisceration. 1,4,6 Our patient did not undergo evisceration given success in controlling the infection with expeditious removal of the buckle components, systemic and topical antibiotic therapy, combined with a continuous antibiotic lavage system.…”

Reduced gray matter volume in patients with retinal detachment: evidence from a voxel-based morphometry study

“…At present, RD remains a common and serious ophthalmic disease that causes blindness. It is a refractory disease with a poor prognosis and high rate of recurrence, after which it is difficult to treat (12). Although it is more common in middle-aged or elderly people, the incidence of RD in younger people has been on the rise in recent years.…”