Acute bilateral postoperative endophthalmitis in a DQ5-positive patient: Possible susceptibility to infections

An unusual case of bilateral acute endophthalmitis in association with the HLA-DQ5 histocompatibility antigen is reported. A 35-year-old woman with hi gh myopia and cataracts in both eyes underwent phacoemulsification procedur es performed in separate sessions using different viscoelastic substances a nd following the same strict prophylactic measures. After each surgical pro cedure, she developed S epidermidis acute endophthalmitis in the right eye and Propionibacterium acnes acute endophthalmitis in the left eye; both wer e successfully treated with capsular bag irrigation and intracameral vancom ycin (1 mg/0.1 mL). She tested positive for the HLA-DQ5 (DQ1), DQ2 antigen. The question is raised as to whether the HLA-DQ5 histocompatibility antige n may be a predisposing factor for both staphylococcal and P Acnes acute en dophthalmitis. A multicenter prospective study is proposed to identify this HLA antigen in all patients scheduled for cataract surgery who have a hist ory of postoperative endophthalmitis in the fellow eye.