A Case of Enterococcus Faecalis Endophthalmitis after Phacoemulsification

ABSTRACT

PURPOSE: To report a case of Enterococcus faecalis endophthalmitis which occurred two days after phacoemulsification and posterior chamber intraocular lens implantation. A vitrectomy performed during the early stage of infection showed retinal and vitreous presentation. We report the clinical manifestation, operative findings, and treatment of this pathogen. METHODS: A healthy, 71-year-old female, presented with a sudden loss of vision and eyeball pain two days after phacoemulsification and intraocular lens implantation. As inflammation of the anterior chamber and vitreous cavity progressed rapidly, we performed intravitreal antibiotics injection (Amikacin, 0.4 mg/0.1 ml, Vancomycin, 1 mg/0.1 ml). Since this was ineffective, pars plana vitrectomy, silicone oil tamponade, and intravitreal antibiotics injection (Vancomycin, 1 mg/0.1 ml) were performed. During the procedure, we noted that the vitreous humor was cloudy and apparently filled with pus. We also noted an edematous retina with hemorrhages and necrotic changes. Enterococcus faecalis was identified on vitreous and aqueous fluid culture. RESULTS: Twelve weeks after vitrectomy, her corrected visual acuity was hand motion and there was no evidence of recurrence.