Eye & contact lens · 2013
Haemophilus influenza endophthalmitis after pterygium surgery.
Клинический случайСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Kolomeyer Anton M, Bhagat Neelakshi, Chu David S
Аннотация
OBJECTIVE: To describe a case of Haemophilus influenza endophthalmitis after pterygium surgery.
METHOD: Retrospective case report.
RESULTS: A 50-year-old Hispanic male underwent a pterygium excision with amniotic membrane graft (AMG) and 0.02% MMC. He presented 3.5 months later with severe pain, yellow-white discharge, and decreased visual acuity for several days, and conjunctival injection for 3 months. Repair of perforation with a corneal graft was performed. Intravitreal antibiotics were administered. Many β-lactamase negative H. influenza organisms were cultured from the vitreous aspirate. The vitritis significantly improved and hypopyon resolved over the next week. The patient underwent surgery for a combined tractional and rhegmatogenous RD 9 days later. The endophthalmitis resolved; however, he developed proliferative vitreoretinopathy (PVR) with redetached retina 21 days after the initial RD repair. He underwent subsequent surgery. Six months later, AMG was performed for recurrent corneal erosion with a large epithelial defect. At last follow-up, the vision remains at hand motions, the retina is flat, there is mild corneal decompensation, the eye is soft to palpation, and there are signs of early phthisis.
CONCLUSIONS: A prospective study to identify the optimal concentration and period of application for MMC, as well as patient characteristics resulting in the highest clinical benefit-to-risk ratio may be warranted.
METHOD: Retrospective case report.
RESULTS: A 50-year-old Hispanic male underwent a pterygium excision with amniotic membrane graft (AMG) and 0.02% MMC. He presented 3.5 months later with severe pain, yellow-white discharge, and decreased visual acuity for several days, and conjunctival injection for 3 months. Repair of perforation with a corneal graft was performed. Intravitreal antibiotics were administered. Many β-lactamase negative H. influenza organisms were cultured from the vitreous aspirate. The vitritis significantly improved and hypopyon resolved over the next week. The patient underwent surgery for a combined tractional and rhegmatogenous RD 9 days later. The endophthalmitis resolved; however, he developed proliferative vitreoretinopathy (PVR) with redetached retina 21 days after the initial RD repair. He underwent subsequent surgery. Six months later, AMG was performed for recurrent corneal erosion with a large epithelial defect. At last follow-up, the vision remains at hand motions, the retina is flat, there is mild corneal decompensation, the eye is soft to palpation, and there are signs of early phthisis.
CONCLUSIONS: A prospective study to identify the optimal concentration and period of application for MMC, as well as patient characteristics resulting in the highest clinical benefit-to-risk ratio may be warranted.