PRELIMINARY-STUDY OF A NEW INTRAOCULAR METHOD IN THE DIAGNOSIS AND TREATMENT OF PROPIONIBACTERIUM ACNES ENDOPHTHALMITIS FOLLOWING CATARACT-EXTRACTION

Late endophthalmitis, due to Propionibacterium acnes, developed in thr ee patients following uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens (PC-IOL) insertion. Cultures fr om the capsular bag yielded P acnes in all three. With topical anesthe sia and through an anterior chamber paracentesis, culture specimens we re taken from and clindamycin irrigated into the capsular bag. Filtere d 100% oxygen was introduced into the anterior chamber in two; the thi rd also received an injection of gentamicin and dexamethasone into the capsular bag. After treatment, two patients received oral antibiotics ; one received hyperbaric oxygen therapy. Visual acuity was improved a nd inflammation reduced in all three. However, after treatment, ocular toxic effects due to clindamycin were suspected in one. This approach offers several clear advantages, including topical anesthesia, outpat ient management, elimination of the need for vitrectomy, and retention of the intraocular lens (IOL).