Bacterial Endophthalmitis Resulting from Radial Keratotomy

Staphylococcus epidermidis endophthalmitis developed nine days after surgery in a 47-year-old man who underwent a 16-incision radial keratotomy during which the cornea was inadvertently perforated. The anterior chamber showed marked cellular reaction and flare and there was a 5% hypopyon inferiorly. There was also a marked cellular reaction in the vitreous, which contained many fluffy white balls. Visual acuity decreased to counting fingers at 1 foot. A pars plana vitrectomy and intraocularly, periocularly, intravenously, and topically administered antibiotics resulted in recovery of the visual acuity to 6/9 (20/30)

A retrospective review of endophthalmitis due to coagulase-negative staphylococci.

We retrospectively reviewed 28 cases of postoperative endophthalmitis due to coagulase-negative staphylococci. There was an average delay between surgery and the acute presentation of 7 X 2 days (SD 3 X 3). All patients were treated with intraocular antibiotics (IOAB) or therapeutic vitrectomy with IOAB. In six of the 28 cases the organisms were resistant to gentamicin as measured by the Kirby-Bauer technique; none was resistant to cephalosporins. Isolates that had been stored by lyophilisation were reconstituted and tested by serial dilution; none was resistant to gentamicin, though two were borderline. The final visual acuity was 6/18 or better in 72% of the eyes