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Postoperative Endophthalmitis after Combined Cataract Extraction and iStent Inject Implantation

Purpose. To report a case of postoperative endophthalmitis after combined cataract extraction and iStent inject implantation. Observation. A 70-year-old male with a nuclear sclerotic cataract and primary open-angle glaucoma underwent an uneventful phacoemulsification cataract extraction with implant...

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Autores principales: Huang, Johnson, Nguyen, Minh T., Tsukikawa, Mai, Chen, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175009/
https://www.ncbi.nlm.nih.gov/pubmed/37181077
http://dx.doi.org/10.1155/2023/3132866
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author Huang, Johnson
Nguyen, Minh T.
Tsukikawa, Mai
Chen, Andrew
author_facet Huang, Johnson
Nguyen, Minh T.
Tsukikawa, Mai
Chen, Andrew
author_sort Huang, Johnson
collection PubMed
description Purpose. To report a case of postoperative endophthalmitis after combined cataract extraction and iStent inject implantation. Observation. A 70-year-old male with a nuclear sclerotic cataract and primary open-angle glaucoma underwent an uneventful phacoemulsification cataract extraction with implantation of an intraocular lens and an iStent inject trabecular bypass stent. The patient was prescribed a postoperative regimen of ofloxacin 0.3% and prednisolone acetate 1%, 1 drop four times a day each. On postoperative day five, he presented to the emergency room for eye pain and had 4+ mixed cells in the anterior chamber (AC) without hypopyon or vitritis on exam. Prednisolone 1% eye drops were increased from four times a day to every two hours while awake. Overnight, he developed worsening vision and severe eye pain. The next morning, he was found to have increased AC cells, vitritis, and intraretinal hemorrhages and was diagnosed with endophthalmitis. The patient underwent a vitreous tap and intravitreal injections of vancomycin (1 mg/0.1 mL) and amikacin (0.4 mg/0.1 mL). Cultures grew Staphylococcus epidermidis. Lab work-up revealed underlying neutropenia. Visual acuity eventually recovered to 20/20. Conclusion and Importance. This report highlights a case of endophthalmitis associated with placement of the iStent inject. The infection was well-controlled after administration of intravitreal antibiotics without removal of the iStent inject, and visual acuity eventually recovered to 20/20. Surgeons should be aware of endophthalmitis risk following combined iStent inject placement, and good recovery is possible without removal of the implant.
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spelling pubmed-101750092023-05-12 Postoperative Endophthalmitis after Combined Cataract Extraction and iStent Inject Implantation Huang, Johnson Nguyen, Minh T. Tsukikawa, Mai Chen, Andrew Case Rep Ophthalmol Med Case Report Purpose. To report a case of postoperative endophthalmitis after combined cataract extraction and iStent inject implantation. Observation. A 70-year-old male with a nuclear sclerotic cataract and primary open-angle glaucoma underwent an uneventful phacoemulsification cataract extraction with implantation of an intraocular lens and an iStent inject trabecular bypass stent. The patient was prescribed a postoperative regimen of ofloxacin 0.3% and prednisolone acetate 1%, 1 drop four times a day each. On postoperative day five, he presented to the emergency room for eye pain and had 4+ mixed cells in the anterior chamber (AC) without hypopyon or vitritis on exam. Prednisolone 1% eye drops were increased from four times a day to every two hours while awake. Overnight, he developed worsening vision and severe eye pain. The next morning, he was found to have increased AC cells, vitritis, and intraretinal hemorrhages and was diagnosed with endophthalmitis. The patient underwent a vitreous tap and intravitreal injections of vancomycin (1 mg/0.1 mL) and amikacin (0.4 mg/0.1 mL). Cultures grew Staphylococcus epidermidis. Lab work-up revealed underlying neutropenia. Visual acuity eventually recovered to 20/20. Conclusion and Importance. This report highlights a case of endophthalmitis associated with placement of the iStent inject. The infection was well-controlled after administration of intravitreal antibiotics without removal of the iStent inject, and visual acuity eventually recovered to 20/20. Surgeons should be aware of endophthalmitis risk following combined iStent inject placement, and good recovery is possible without removal of the implant. Hindawi 2023-05-04 /pmc/articles/PMC10175009/ /pubmed/37181077 http://dx.doi.org/10.1155/2023/3132866 Text en Copyright © 2023 Johnson Huang et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Huang, Johnson
Nguyen, Minh T.
Tsukikawa, Mai
Chen, Andrew
Postoperative Endophthalmitis after Combined Cataract Extraction and iStent Inject Implantation
title Postoperative Endophthalmitis after Combined Cataract Extraction and iStent Inject Implantation
title_full Postoperative Endophthalmitis after Combined Cataract Extraction and iStent Inject Implantation
title_fullStr Postoperative Endophthalmitis after Combined Cataract Extraction and iStent Inject Implantation
title_full_unstemmed Postoperative Endophthalmitis after Combined Cataract Extraction and iStent Inject Implantation
title_short Postoperative Endophthalmitis after Combined Cataract Extraction and iStent Inject Implantation
title_sort postoperative endophthalmitis after combined cataract extraction and istent inject implantation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175009/
https://www.ncbi.nlm.nih.gov/pubmed/37181077
http://dx.doi.org/10.1155/2023/3132866
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