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Macular edema associated with intraocular ointment after cataract surgery

PURPOSE: To report a case with macular edema associated with uveitis, a decreased corneal endothelial cell density, and vitreous opacity caused by migrated intraocular antibiotic ointment after uneventful cataract surgery. OBSERVATIONS: A 63-year-old man underwent uneventful sutureless superior clea...

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Autores principales: Kudo, Asaka, Kudo, Takashi, Takahashi, Daisuke, Metoki, Tomomi, Suzuki, Yukihiko, Nakazawa, Mitsuru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5956708/
https://www.ncbi.nlm.nih.gov/pubmed/29780926
http://dx.doi.org/10.1016/j.ajoc.2018.02.027
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author Kudo, Asaka
Kudo, Takashi
Takahashi, Daisuke
Metoki, Tomomi
Suzuki, Yukihiko
Nakazawa, Mitsuru
author_facet Kudo, Asaka
Kudo, Takashi
Takahashi, Daisuke
Metoki, Tomomi
Suzuki, Yukihiko
Nakazawa, Mitsuru
author_sort Kudo, Asaka
collection PubMed
description PURPOSE: To report a case with macular edema associated with uveitis, a decreased corneal endothelial cell density, and vitreous opacity caused by migrated intraocular antibiotic ointment after uneventful cataract surgery. OBSERVATIONS: A 63-year-old man underwent uneventful sutureless superior clear corneal phacoemulsification and implantation of an intraocular lens in his right eye. Eleven months later, he complained of blurred vision when he gazed downward. Three months later, uveitis, vitreous opacity, and retinal hemorrhage were noted. Optical coherence tomography and fluorescein angiography demonstrated macular edema in the right eye. A slit-lamp examination revealed many tiny oily deposits on the iris surface. One month later, a globular oily droplet was detected at the 12 o'clock position of the iridocorneal angle. Because the corneal endothelial cell density appeared to be progressively decreased, the oily droplet was removed, and the anterior chamber was irrigated with a balanced salt solution using an irrigation-aspiration cannula. After surgery, the macular edema, vitreous opacity, and retinal hemorrhage disappeared. CONCLUSIONS AND IMPORTANCE: In this case, ofloxacin ointment had presumably migrated into the anterior chamber through a corneal incision after cataract surgery. The fact that the droplet of ointment was able to be detected more than one year after the cataract surgery suggests that dispersed tiny droplets can slowly coalesce into a globular droplet and wander between the anterior and posterior chambers, thereby causing uveitis, corneal endothelial cell damage, and macular edema. The removal of the intraocular ointment resolved these complications. This is the second report of intraocular ointment causing macular edema.
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spelling pubmed-59567082018-05-18 Macular edema associated with intraocular ointment after cataract surgery Kudo, Asaka Kudo, Takashi Takahashi, Daisuke Metoki, Tomomi Suzuki, Yukihiko Nakazawa, Mitsuru Am J Ophthalmol Case Rep Case report PURPOSE: To report a case with macular edema associated with uveitis, a decreased corneal endothelial cell density, and vitreous opacity caused by migrated intraocular antibiotic ointment after uneventful cataract surgery. OBSERVATIONS: A 63-year-old man underwent uneventful sutureless superior clear corneal phacoemulsification and implantation of an intraocular lens in his right eye. Eleven months later, he complained of blurred vision when he gazed downward. Three months later, uveitis, vitreous opacity, and retinal hemorrhage were noted. Optical coherence tomography and fluorescein angiography demonstrated macular edema in the right eye. A slit-lamp examination revealed many tiny oily deposits on the iris surface. One month later, a globular oily droplet was detected at the 12 o'clock position of the iridocorneal angle. Because the corneal endothelial cell density appeared to be progressively decreased, the oily droplet was removed, and the anterior chamber was irrigated with a balanced salt solution using an irrigation-aspiration cannula. After surgery, the macular edema, vitreous opacity, and retinal hemorrhage disappeared. CONCLUSIONS AND IMPORTANCE: In this case, ofloxacin ointment had presumably migrated into the anterior chamber through a corneal incision after cataract surgery. The fact that the droplet of ointment was able to be detected more than one year after the cataract surgery suggests that dispersed tiny droplets can slowly coalesce into a globular droplet and wander between the anterior and posterior chambers, thereby causing uveitis, corneal endothelial cell damage, and macular edema. The removal of the intraocular ointment resolved these complications. This is the second report of intraocular ointment causing macular edema. Elsevier 2018-03-02 /pmc/articles/PMC5956708/ /pubmed/29780926 http://dx.doi.org/10.1016/j.ajoc.2018.02.027 Text en © 2018 Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case report
Kudo, Asaka
Kudo, Takashi
Takahashi, Daisuke
Metoki, Tomomi
Suzuki, Yukihiko
Nakazawa, Mitsuru
Macular edema associated with intraocular ointment after cataract surgery
title Macular edema associated with intraocular ointment after cataract surgery
title_full Macular edema associated with intraocular ointment after cataract surgery
title_fullStr Macular edema associated with intraocular ointment after cataract surgery
title_full_unstemmed Macular edema associated with intraocular ointment after cataract surgery
title_short Macular edema associated with intraocular ointment after cataract surgery
title_sort macular edema associated with intraocular ointment after cataract surgery
topic Case report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5956708/
https://www.ncbi.nlm.nih.gov/pubmed/29780926
http://dx.doi.org/10.1016/j.ajoc.2018.02.027
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