Noninfectious endophthalmitis occurring after intravitreal triesence injection.

PURPOSE: To report a case of noninfectious endophthalmitis occurring after intravitreal Triesence (preservative-free triamcinolone acetonide) injection.

METHOD: Case report.

RESULTS

A 62-year-old patient with macular edema occurring after cataract surgery received 0.1 mL (4 mg) of intravitreal Triesence to the left eye. His vision was 20/60. One day later, he presented with a decrease in vision to light perception upon awakening. He denied ocular pain, and the eye was not red. Clinical examination was remarkable for orbital proptosis, minimal fibrin on the anterior chamber intraocular lens, and a white hypopyon. There was no view of the retina due to vitreous opacities. A vitreous tap and injection of intravitreal Ceftazidime and Vancomycin were performed. Microbiology showed no organisms on gram stain, and the cultures were negative. The endophthalmitis resolved, and the patient recovered vision to 20/70.

CONCLUSIONS

Noninfectious endophthalmitis can occur after preservative-free commercially available intravitreal Triesence. This case suggests that noninfectious endophthalmitis can occur in the absence of the benzyl alcohol found in preserved preparations of Kenalog.