J Korean Ophthalmol Soc.  2007 Jan;48(1):172-178.

A Case of Endophthalmitis after 25-gauge Transconjunctival Sutureless Vitrectomy

• Lee JW
• Kim DJ
• Shin JP
• Kim SY

Abstract

PURPOSE: To report a case of endophthalmitis after 25-gauge transconjunctival sutureless vitrectomy.
METHODS
A 60-year-old male patient underwent 25-gauge transconjunctival sutureless vitrectomy through the epiretinal membrane. He was diagnosed as endophthalmitis on 7th postoperative day. Immediate vitrectomy and intravitreal antibiotics injection was done.
RESULTS
Coagulase-negative staphylococcus was identified in vitreous culture and incarcerated vitreous through the previous unsutured sclerotomies were found. During vitrectomy, we found generalized retinal necrosis and vascular occlusion with retinal hemorrhage, cheese like thick membrane firmly adherent to the retina due to inflammatory response. The organism was sensitive to antibiotics administered. After treatment, inflammatory response was controlled and the retina became stable but the visual outcome was poor.
CONCLUSIONS
Vitreous incarceration through unsutured sclerotomy may occur after 25-gauge transconjunctival sutureless vitrectomy. This can be a possible conduit for bacteria in the eye and be a cause of endophthalmitis. Sutureless sclerotomy should be carefully monitered and managed postoperatively.

Keyword

25-gauge transconjunctival sutureless vitrectomy; Endophthalmitis; Coagulase-negative staphylococcus

MeSH Terms

Anti-Bacterial Agents
Bacteria
Cheese
Endophthalmitis*
Epiretinal Membrane
Humans
Male
Membranes
Middle Aged
Necrosis
Retina
Retinal Hemorrhage
Retinaldehyde
Staphylococcus
Vitrectomy*
Anti-Bacterial Agents
Retinaldehyde