Experimental bacterial endophthalmitis following extracapsular lens extraction

Records, Raymond E.; Iwen, Peter C.

doi:10.1016/s0014-4835(89)80034-x

Cited by 32 publications

(5 citation statements)

References 15 publications

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“…If the posterior lens capsule is not intact, the risk of bacterial endophthalmitis increases and the bacterial inoculum size necessary to cause endophthalmitis is significantly reduced. 36,37 Although no eyes in this study developed culture-confirmed infectious endophthalmitis, one patient developed hypopyon, fibrin within the anterior chamber, and reduced media clarity in one eye 7 days postoperatively (Fig. 1).…”

Section: Discussionmentioning

confidence: 77%

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Microbial contamination of the anterior chamber during cataract phacoemulsification and intraocular lens implantation in dogs

Ledbetter

Millichamp

Dziezyc

2004

Veterinary Ophthalmology

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The objective of this study was to determine the frequency of intraoperative contamination of the anterior chamber with viable microorganisms during cataract phacoemulsification and intraocular lens implantation, and to evaluate the relationship of contaminant microorganisms to patients' extraocular and nasal cavity floras. Also, the impact of various aspects of the patient history and phacoemulsification procedure on the incidence of positive postoperative anterior chamber cultures was investigated. Twenty-two eyes from 13 dogs presented for elective cataract phacoemulsification and intraocular lens implantation were studied. Preoperatively, microbiologic samples of the conjunctiva, eyelid margins, nares, and rostral nasal cavity were collected. Postoperatively, anterior chamber fluid was aspirated. Samples were submitted for aerobic/anaerobic bacteriologic culture and antimicrobial susceptibility, Mycoplasma culture, and fungal culture. Anterior chamber aspirates collected at the conclusion of surgery were culture positive for at least one organism in 22.7% of eyes. Three aerobic bacteria and three fungi were isolated from the anterior chamber aspirates. Two fungi and one bacterium isolated from the anterior chamber were typed identically, and the bacterium had a similar antibiogram to organisms recovered from the patient's conjunctiva and eyelid margin. No statistically significant difference in contamination frequency was found for the investigated patient and surgical variables. We conclude that intraoperative contamination of the anterior chamber with viable bacterial and fungal organisms is a common occurrence in canine patients undergoing cataract phacoemulsification and intraocular lens implantation, and the external ocular flora is a likely source of some of these contaminating microorganisms. This contamination is independent of the patient and surgical variables investigated.

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Section: Discussionmentioning

confidence: 77%

“…An intact posterior lens capsule serves as a barrier to prevent organisms from entering the vitreous humor from the anterior chamber. If the posterior lens capsule is not intact, the risk of bacterial endophthalmitis increases and the bacterial inoculum size necessary to cause endophthalmitis is significantly reduced 36,37 …”

Section: Discussionmentioning

confidence: 99%

Microbial contamination of the anterior chamber during cataract phacoemulsification and intraocular lens implantation in dogs

Ledbetter

Millichamp

Dziezyc

2004

Veterinary Ophthalmology

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“…Endogenous endophthalmitis develops when pathogens cross the blood-ocular barrier, resist the body's immune system, and proliferate within the eye [2]. The blood-ocular barrier is thought to be strong in most cases, as only few pathogens in the vitreous cavity can lead to endophthalmitis [3]. Presenting symptoms include eye pain and blurry vision; hypopyon, a collection of white blood cells in the anterior chamber, may be present on exam [2].…”

Section: Introductionmentioning

confidence: 99%

Endogenous Endophthalmitis: yield of the diagnostic evaluation

et al. 2020

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Background: Endogenous endophthalmitis is an infection of the eye secondary to sepsis, occurring in 0.04-0.5% of bacteremia or fungemia. Risk factors include intravenous drug abuse (IVDA), diabetes, indwelling catheters, and immune suppression. Many patients have known or suspected bacteremia or fungemia; however, culture yield is reported to be low (approximately 50%). The purpose of this study is to elucidate the yield of diagnostic evaluation including microbial cultures over a 6.5 year period at an academic center in the United States. Methods: Retrospective chart review of patients with endogenous endophthalmitis at the University of Florida from June 2011 to February 2018. Results: Included are 40 eyes of 35 patients. Endophthalmitis was secondary to an endogenous source in 23.5% of all endophthalmitis cases observed. Intraocular culture positivity was 28.6% overall but was 0% after initiation of systemic antibiotics. Most commonly identified organisms from the eye were coagulase-negative Staphylococcus and Candida. Blood culture positivity was 48.6%, most commonly Staphylococcus. IVDA was noted with increasing frequency as a risk factor. Diagnosis of endophthalmitis upon hospital admission was associated with a higher intraocular culture positivity (P = 0.040) and a shorter hospital stay (P = 0.035). Computed tomography (CT) and magnetic resonance imaging (MRI) were the highest yield imaging modalities; X-ray and non-ocular ultrasound were less diagnostically useful. Echocardiogram was positive by transesophageal route (TEE) in 22% and in 9% by transthoracic (TTE) testing. Following discharge from the hospital, 48.4% of patients failed to follow up with outpatient ophthalmology. Conclusions: Based on the results of this study, the interdisciplinary team should consider directed imaging, eye cultures prior to antimicrobial administration, thorough history for IVDA, and caution with premature discharge from the hospital.

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“…These results were confirmed in a later study [93]in which the authors showed that the presence of a posterior chamber intraocular lens did not appreciably compromise the barrier function of the posterior capsule. In a similar study, Records and Iwen [94]used rabbits to determine if extracapsular lens extraction enhanced the ability of S. aureus to infect the anterior chamber and to assess the ability of the posterior capsule to act as a barrier against the spread of bacteria into the vitreous. Results from this study showed that extracapsular cataract extraction does not predispose the eye to bacterial endophthalmitis if the posterior capsule remained intact and that release of lens proteins and other constituents had little effect on growth of the organism.…”

Section: General Information From Experimentalmodelsmentioning

confidence: 99%