Staphylococcus Haemoliticus Endophthalmitis Following Cataract Surgery: Clinical and Surgical Management


SCIENTIFIC POSTER

Staphylococcus Haemoliticus Endophthalmitis Following Cataract Surgery Clinical and Surgical Management by Sborgia L.


ABSTRACT

Purpose:

To report clinical features, surgical management, antibiotic susceptibility, and visual and anatomic outcomes in a Staphylococcus Haemoliticus endophthalmitis case series that occurred after cataract surgery.

Introduction:

Postoperative endophthalmitis following cataract surgery has an incidence rate between 0.1 and 0.2% and could have devastating morphologic and functional consequences. Endophthalmitis from Staphylococcus haemolyticus is a rare cause of endophthalmitis in the postoperative setting following cataract surgery, with an incidence of 0.002%.

Methods:

Ophthalmologic examinations, treatment methods, antibiotic susceptibility, and final examinations of 4 patients who had endophthalmitis after cataract surgery in our clinic were evaluated retrospectively.

Results:

All patients underwent phacoemulsification and intraocular lens implantation in the same surgical session. They complained ocular pain and severe visual loss ranged from hand motion to light perception within 72-96 hours after surgery. Analysis on surgical equipment and operating room staff was performed and resulted negative. All patients underwent a three port pars plana vitrectomy 25-Gauge within 4 hours from emergency room admittance. IOL explantation was performed except in one patient. Vitreous was removed as possible and its sample was analyzed. Finally we performed an intravitreal injection of Amikacin 0,4mg/0,1 ml and Vancomycin 1 mg/0,1 ml, and silicone oil tamponade was performed. Vitreous samples of all patients revealed Staphylococcus Haemolyticus sensitive to vancomycin, rifampicin and fusidic acid. So sistemic rifampicin and topic fusidic acid were started. In three patients silicon oil was removed two months later. At last follow-up (3 months after vitrectomy) three patients showed a BCVA ≥0.3 LogMAR. In the last patient iris neovascularization due to Central Retinal Artery Occlusion developed rapidly after vitrectomy. This patient underwent retinal laser photocoagulation and silicon oil was not removed.

Conclusion:

Although Staphylococcus Haemoliticus is an uncommon bacterium of postoperative endophtalmitis, it should be considered as a noteworthy pathogenic agent in patient underwent cataract surgery. Endophthalmitis treatment should be planned for each patient individually, according to their clinical presentation. Clinical and visual outcomes in our experience could be various and probably related to initial presentation.


CONTACT DETAILS

Sborgia L., Nacucchi A., Puzo P., Giuliani G., Sborgia G., Sborgia A., Recchimurzo N., Furino C., Niro A., Gigliola S., Galeone A., and Alessio G.
Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy
Pasquale Puzo
Email : puzopasquale@gmail.com