Propionibacterium acnes endophthalmitis requiring intraocular lens removalafter failure of medical therapy

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.