Acute-onset postoperative endophthalmitis after cataract surgery and transzonular intravitreal triamcinolone-moxifloxacin

Abstract

Purpose: To report 4 cases of acute postoperative endophthalmitis (POE) after uneventful temporal clear corneal topical dropless cataract surgery involving intravitreal triamcinolone-moxifloxacin (TriMoxi).

Setting: Private practice in Peoria, IL, USA.

Design: Retrospective noncomparative case series.

Methods: Charts of patients presenting with POE after an uneventful temporal clear corneal phacoemulsification with in-the-bag implantation of a posterior chamber intraocular lens over a 15-month period were reviewed.

Results: Patients presented with typical signs and symptoms of acute POE 3 to 14 days after cataract surgery. The POE resolved after 25-gauge pars plana vitrectomy and injection of intravitreal vancomycin, ceftazidime, and dexamethasone. Two of 4 eyes were culture-positive for coagulase-negative Staphylococcus. The corrected distance visual acuity at the last follow-up visit was 20/40 or better in 3 eyes, and 20/400 in 1 eye because of underlying atrophic age-related macular degeneration.

Conclusion: Postoperative endophthalmitis can occur after dropless cataract surgery with intravitreal triamcinolone-moxifloxacin.