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Source of late-onset endophthalmitis often the patient, study suggests
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NUREMBERG, Germany — Late-onset endophthalmitis after cataract surgery with a sutureless incision may often be caused by patients rubbing or touching their eyes, a study presented here suggests.
Cosme I.N. Naval, MD, and A.T. Suntay, MD, reviewed six cases of endophthalmitis that developed 3 to 14 days after uncomplicated phacoemulsification. Dr. Naval presented the results of the study here at the German Ophthalmic Surgeons meeting.
Dr. Naval said all cases had positive isolates that indicated the source of the infection was the patient. In three cases, the bacteria were identical to those seen in a respiratory infection, two cases showed the source to be bacteria normally found on the skin, and in one case the source was related to a nasolacrimal duct tube implanted in the patient’s fellow eye.
Dr. Naval noted that in five of the six cases the primary site of the bacterial invasion was the vitreous, probably due to an intermittent postop wound leak.
He said touching of the eyes by the patients probably transmitted the infection.
“A sutureless incision may be closed at the time of surgery but may be opened by rubbing,” he said.
Early vitrectomy saved the eyesight in four of the six patients (66.6%), but delayed treatment of the remaining two cases resulted in vision loss, he said.