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- Title
An outbreak of forty five cases of Pseudomonas aeruginosa acute endophthalmitis after phacoemulsification.
- Authors
LEITÃO GUERRA, RICARDO LUZ; DE PAULA FREITAS, BRUNO; MEDRADO PARCERO, CINTIA MARIA FELIX; DE OLIVEIRA MAIA JÚNIOR, OTACÍLIO; MARBACK, ROBERTO LORENS
- Abstract
Purpose: To describe an outbreak of Pseudomonas aeruginosa endophthalmitis post cataract surgery. Clinical findings, treatment and outcome are discussed. Methods: Clinical charts review of forty-five patients treated for endophthalmitis in a two-day period. The patients underwent primary vitrectomy, anterior chamber irrigation and intravitreous antibiotic injection. Cultures from vitreous and anterior chamber samples were performed in all patients. Results: Forty-five patients (twenty-three men and twenty-two women) were identified. The average age was 71.2 years (range, 56-83 years). The right eye (62%) was affected more often than the left eye (38%). The median interval between surgery and endophthalmitis onset was 5.5 days (range, 5-6 days). The visual acuity at the diagnosis was better than 20/40 in one patient (2%), from 20/40 to 20/200 in one patient (2%), from 20/400 to counting fingers in two patients (4%), hand movements in eleven patients (24%), and light perception in thirty patients (68%). Pseudomonas aeruginosa was the isolated agent in twenty-six vitreous samples and in three anterior chamber samples. Overall, one patient (2%) achieved a final visual acuity better than 20/40; eight patients (18%) achieved a final visual acuity from 20/40 to 20/200; six patients (13%) achieved a final visual acuity from 20/400 to counting fingers; eleven patients (25%) achieved a final acuity of hand movements; thirteen patients (29%) achieved a final acuity of light perception and six (13%) patients had no light perception at the last examination. None of these eyes underwent evisceration or enucleation in a three-month follow-up period. Conclusion: Even with all the safety that cataract surgery has achieved, today, endophthalmitis remains a risk and a fearful complication of this procedure. In the present study, it was impossible to identify the source of the outbreak.
- Subjects
CATARACT surgery complications; PSEUDOMONAS aeruginosa; PSEUDOMONAS diseases; PHACOEMULSIFICATION; VITRECTOMY; VISUAL acuity
- Publication
Arquivos Brasileiros de Oftalmologia, 2012, Vol 75, Issue 5, p344
- ISSN
0004-2749
- Publication type
Article
- DOI
10.1590/S0004-27492012000500010