Postoperative Panophthalmitis in a Silicone Oil-Filled Eye: A Case Report and Review of the Literature.

PURPOSE: To report the first documented case of postoperative endophthalmitis progressing to panophthalmitis in a silicone oil-filled eye (SO) following pars plana vitrectomy (PPV), and to review the relevant literature.

METHODS

A single case of postoperative endophthalmitis that progressed to panophthalmitis following PPV with heavy SO tamponade was retrospectively reviewed, including clinical presentation, imaging, microbiological investigations, management, and outcomes. A focused literature review was conducted to identify previously reported cases of post-vitrectomy and SO-related panophthalmitis.

RESULTS

A 42-year-old woman presented two weeks after PPV with rapidly progressive ocular pain, periocular swelling, proptosis, restricted extraocular motility, and severe intraocular inflammation. B-scan ultrasonography demonstrated dense inflammatory opacities within the SO-filled vitreous cavity. Despite prompt intravitreal and systemic broad-spectrum antibiotics, an intraocular sample yielded no microbial growth on culture, and the visual outcome was poor, with progression toward a pre-phthisical eye.

CONCLUSION

Endophthalmitis progressing to panophthalmitis is exceedingly rare in SO-filled eyes. Diagnostic sampling and intravitreal therapy carry specific technical challenges in this setting, evidence for management is limited, and visual outcomes remain poor.