Endophthalmitis secondary to corneal sutures: series of delayed-onset keratitis requiring intravitreal antibiotics

Khurshid, Gibran S.; Fahy, Gerry

doi:10.1016/s0886-3350(03)00404-8

Cited by 27 publications

(24 citation statements)

References 9 publications

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“…Khurshid et al [18] documented 5 cases of suture induced endophthalmitis. In contrast to our patient, these patients presented over a period of 19 months with suture-related bacterial keratitis that progressed to endophthalmitis.…”

Section: Discussionmentioning

confidence: 99%

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Fulminant Culture Negative Endophthalmitis as a New Entity, Toxic Posterior Segment Syndrome?

LoBue¹

2016

AOVS

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Purpose: To report an unusual case of sterile versus bacterial endophthalmitis in a post cataract surgery wound leak Subject: A 58-year-old woman with a past eye medical history of LASIK underwent routine cataract extraction (CE) with lens implant of left eye and presented with a delayed, fulminant endophthalmitis OS on day 19 post CE or 3.5 days after the development of a post-op wound leak. Eye examination OS showed visual acuity (VA) of bare LP. Slit lamp examination revealed an edematous cornea with a 1mm hypopyon. A large amount of exudate filled the entire posterior segment.Results: Patient was treated with intravitreal vancomycin (1mg) and ceftazidime (2mg) and pars plana vitrectomy. Vitreal cultures were negative, but initial clinical presentation mimicked a virulent strep, staph, or pseudomonas endophthalmitis. Her postoperative course showed gradual improvement, reaching baseline VA of 20/30 OS with a normal eye exam. Conclusion:Although culture-negative bacterial endophthalmitis is common, good visual outcomes with virulent bacteria is not. Fulminant culture-negative endophthalmitis with a good visual outcome may be due to a sterile toxic insult, a variation of TASS which we call Toxic Posterior Segment Syndrome (TPSS).

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Section: Discussionmentioning

confidence: 99%

“…Also, Culbert et al [19] documented 3 cases of endophthalmitis after suture removal. Loose sutures may serve as a nidus for bacterial growth causing inflammation and tissue breakdown, leading to endophthalmitis [18]. One drop of ciprofloxacin was used before suture removal on postoperative day 15.…”

Section: Discussionmentioning

confidence: 99%

Fulminant Culture Negative Endophthalmitis as a New Entity, Toxic Posterior Segment Syndrome?

LoBue¹

2016

AOVS

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“…In addition to causing a foreign-body sensation, sutures may induce astigmatism 1,2 and corneal neovascularization 3 or be a nidus for infection. 1,4,5 Unless biodegradable materials are used, the sutures must be removed. For these reasons, we believe that an ophthalmic tissue adhesive with specific characteristics aimed at the needs of common ophthalmic surgical procedures would have clinical value.…”

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confidence: 99%

Synthesis and characterization of a chondroitin sulfate-polyethylene glycol corneal adhesive

Strehin

Ambrose

Schein

et al. 2009

Journal of Cataract and Refractive Surgery

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“…The only 2 related studies 8,11 report corneal infections leading to endophthalmitis after extracapsular cataract surgery. In addition, Kehdi et al 14 and Cosar et al 15 report a combined 12 patients with corneal wound infections after sutureless clear corneal cataract surgery.…”

Section: Discussionmentioning

confidence: 99%

“…10 The potential morbidity associated with suture-related infections is illustrated by a case series of 4 patients who developed endophthalmitis after extracapsular cataract extraction with PC IOL implantation. 11 We report 3 patients who developed corneal infectious complications due to loose or broken corneal sutures after clear corneal cataract surgery.…”

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confidence: 99%

Suture-related corneal infections after clear corneal cataract surgery

Lee

Smith

Jeng

2009

Journal of Cataract and Refractive Surgery

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Three patients at our institution developed corneal infections associated with sutures placed after clear corneal incision cataract surgery. The time to infection was 9 weeks, 22 months, and 33 months. One patient required injection of intravitreal antibiotic agents for presumed endophthalmitis associated with the corneal infection. Two patients were treated with topical fortified antibiotic eyedrops only. Although there was no significant change in visual acuity after resolution of the infection, morbidity from suture-related corneal infections can be significant. Routine suture removal in the early postoperative period may be warranted to prevent such infections.

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Endophthalmitis secondary to corneal sutures: series of delayed-onset keratitis requiring intravitreal antibiotics

Abstract: Corneal sutures are a risk factor for infective keratitis irrespective of their site. Suture-related keratitis may progress rapidly to endophthalmitis despite intensive topical antibiotics. Intravitreal antibiotics are indicated when endophthalmitis is present.

Cited by 27 publications

References 9 publications

Fulminant Culture Negative Endophthalmitis as a New Entity, Toxic Posterior Segment Syndrome?

Fulminant Culture Negative Endophthalmitis as a New Entity, Toxic Posterior Segment Syndrome?

Synthesis and characterization of a chondroitin sulfate-polyethylene glycol corneal adhesive

Suture-related corneal infections after clear corneal cataract surgery

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