RECURRENT ENDOPHTHALMITIS AFTER CATARACT-SURGERY WITH A SCLERAL-TUNNEL INCISION

Purpose. To present a case of recurrent postoperative endophthalmitis with a scleral-tunnel abscess and adjacent microbial keratitis. Method s. A 76-year-old woman with microbial keratitis and recurrent endophth almitis after cataract surgery was referred to a tertiary care center for further management. The medical chart of the patient was reviewed. Results, The patient was seen on the eighth postoperative day with en dophthalmitis that responded to medical treatment. initial vitreous cu ltures were negative. The endophthalmitis recurred after the medical t reatment was discontinued. She subsequently developed microbial kerati tis at 1 o'clock adjacent to the limbus. Cultures from the site of cor neal abscess and vitreous grew coagulase-negative Staphylococcus. Goni oscopy revealed the presence of a scleral abscess, which responded to subconjunctival injection of vancomycin and an intense and prolonged c ourse of topical antibiotics. Conclusion, A scleral abscess should be suspected in a patient with endophthalmitis or microbial keratitis or both after a scleral-tunnel incision for cataract surgery.