Propionibacterium acnes isolated from explanted intraocular lens in pseudophakic bullous keratopathy.

Propionibacterium acnes is an anaerobic bacterium that has been reported to produce ocular infection or inflammation following surgery or penetrating trauma. It has been well documented as an etiologic agent associated with infections of prosthetic implants, including intraocular lenses (IOLs). P. acnes is part of the natural flora of the external eye and has biological properties that may promote, heighten, or prolong an inflammatory response. It not only resists in vitro degradation by reticuloendothelial cells, but also demonstrates adjuvant properties in vivo. In this study, we cultured the IOLs removed from patients undergoing routine penetrating keratoplasty for pseudophakic bullous keratopathy (PBK). Four of the 12 IOLs were culture positive for P. acnes as late as 36 months postimplantation. Although this does not describe a role for P. acnes in PBK, it does suggest that the organism can remain in the pseudophakic eye for an extended time.