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Year : 2020  |  Volume : 58  |  Issue : 3  |  Page : 200-202

Conservative approach in the management of chronic postoperative Propionibacterium acnes endophthalmitis: A case report with review of literature

1 Department of Vitreo-Retina, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
2 Department of Oculoplasty and Community Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
3 Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India

Correspondence Address:
Dr. Ronel Soibam
Department of Vitreo-Retina, Sri Sankaradeva Nethralaya, 96, Beltola, Guwahati - 781 028, Assam
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjosr.tjosr_20_20

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Chronic endophthalmitis can occur following uncomplicated cataract surgery with intraocular lens (IOL) implantation secondary to slow-growing organisms such as Propionibacterium acnes. A 68-year-old male presented with pain and diminution of vision 4 months after uneventful phacoemulsification with IOL implantation. Slit-lamp examination showed trace hypopyon, conjunctival congestion with anterior chamber cells and flare, vitreous haze, and posterior capsular plaque-like deposits suggestive of probable P. acnes endophthalmitis. Intravitreal antibiotics did not provide any relief. The diagnosis was confirmed using PCR on the aqueous aspirate. Intracameral and in-the-bag injection of antibiotic caused the resolution of infection and improvement in visual acuity. This report thus highlights that in-the-bag antibiotics can help conservatively manage this condition without the need for an invasive procedure like vitrectomy and IOL explantation.

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