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Chronic Recurrent Methicillin Resistant Staphylococcus Hemolyticus Endophthalmitis after Cataract Surgery
백내장수술 후 발생한 만성 재발 메티실린 내성 용혈포도상구균 안내염
JKOS 2019 Jul;60(7):701-5
Published online July 15, 2019;
Copyright © 2019 The Korean Ophthalmological Society.
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Dae Sung Kim, MD, Min Jee Lee, MD, PhD, Min Cheol Seong, MD, PhD, Min Ho Kang, MD, PhD, Hee Yoon Cho, MD, PhD, Yong Un Shin, MD, PhD

Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
한양대학교 의과대학 안과학교실
Received September 13, 2018; Revised November 25, 2018; Accepted June 19, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: To report a case of recurrent endophthalmitis due to methicillin resistant Staphylococcus hemolyticus after phacoemulsification and posterior chamber intraocular lens (IOL) implantation.
Case summary: A 76-year-old female visited our outpatient clinic with decreased vision 40 days after uncomplicated cataract surgery in her right eye. At the visit, anterior chamber inflammation and cloudy fluid between the posterior capsule and IOL were observed. Uveitis due to residual cortex of lens or capsular block syndrome was suspected, so YAG laser capsulotomy and subconjunctival injection of dexamethasone were performed. Two days later, hypopyon and vitreous opacity were seen. The patient underwent an emergency vitrectomy and intravitreal antibiotic injection with suspicion of bacterial endophthalmitis. The culture was negative. Twenty days after the vitrectomy, anterior chamber inflammation and vitreous opacity developed. The recurrence of endophthalmitis was suspected due to infection by bacteria in the surrounding tissue of the IOL, so the patient underwent an IOL and lens capsule removal with intravitreal antibiotic injection. At this time, the culture revealed methicillin resistant staphylococcus hemolyticus. Systemic and topical vancomycin was then administered, resulting in decreased inflammation. Twenty days after the IOL removal, decreased vision, anterior chamber inflammation, and vitreous opacity developed. Endophthalmitis was decreased by intravitreal antibiotic injection and topical antibiotic treatment.
Conclusions: Methicillin resistant staphylococcus hemolyticus should be considered in the differential diagnosis of chronic recurrent endophthalmitis after cataract surgery.
Keywords : Endophthalmitis, Methicillin resistant Staphylococcus, Recurrent


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