ANTIBIOTIC IRRIGATION OF THE CAPSULAR BAG TO RESOLVE LOW-GRADE ENDOPHTHALMITIS

Chronic, low-grade endophthalmitis after cataract surgery with intraoc ular lens (IOL) implantation is often unresponsive to antibiotic thera py, probably because of low drug penetration into the capsular bag. To increase the drug concentration at the infection site, we irrigated t he capsular bag with antibiotics, Within 6 weeks, endophthalmitis reso lved in three consecutive patients with positive aqueous cultures. Vis ual acuity improved from finger counting or less to 20/40 or better in all cases. No recurrence was seen in the 12 to 19 month follow-up. An tibiotic irrigation of the capsular bag can resolve chronic, low-grade endophthalmitis in culture-positive patients unresponsive to the same drugs administered by other routes, including conventional intraocula r injection. With this approach there is minimal surgical trauma and t he IOL is retained.