A 52-year-old Saudi man developed intraocular inflammation 7 weeks after un
eventful phacoemulsification with implantation of a silicone posterior cham
ber intraocular lens (IOL). Cultures from the aqueous and vitreous were rep
eatedly negative, but a temporary response to intracameral and intravitreal
injection of vancomycin was noted. A series of 6 intraocular injections gi
ven over 5 days failed to resolve the inflammation. it did, however, disapp
ear after the IOL was removed. The IOL provided the only positive culture i
n this case of Propionibacterium acnes endophthalmitis. Nine months later,
a posterior chamber poly(methyl methacrylate) IOL was implanted. Eighteen m
onths later, the patient had no recurrences. He regained a visual acuity of
20/30, corresponding to his best postoperative result. J Cataract Refract
Surg 2000; 26:1085-1088 (C) 2000 ASCRS and ESCRS.