| A Case of Delayed Infective Endophthalmitis Associated with Exposure of Scleral Fixation Knot. |
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Seok Jae Lee, Kang Yoon Park, Han Jo Kwon, Sung Who Park, Ji Eun Lee |
1Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea. jlee@pusan.ac.kr
2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. |
| 공막고정매듭 노출과 동반되어 발생한 지연성 감염성 안내염 1예 |
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이석재1⋅박강윤1⋅권한조1⋅박성후1,2⋅이지은1,2 |
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부산대학교 의학전문대학원 안과학교실1, 부산대학교병원 의생명연구원2 |
Correspondence:
Ji Eun Lee,
Email: jlee@pusan.ac.kr
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Received: 27 October 2016 • Revised: 28 December 2016 • Accepted: 17 February 2017 |
| Abstract |
PURPOSE
To report a case of delayed infective endophthalmitis associated with exposure of scleral fixation knot. CASE SUMMARY: A 35-year-old female was transferred from a local clinic with sudden onset right eye pain under suspicion of uveitis. The patient received vitrectomy, scleral encircling and lensectomy for rhegmatogenous retinal detachment before 16 years. In addition, she underwent secondary scleral fixation of intraocular lens (IOL) 1 year previously. Best-corrected visual acuity was hand motion and intraocular pressure was 28 mmHg. Slit lamp examination revealed diffuse keratic precipitates and anterior chamber reaction was 4 positive. Exposed scleral fixation knot outside conjunctiva at 2 o' clock combined with suppurative discharge was observed. On fundus examination, red reflex was decreased due to vitreous haze. She was diagnosed as infective endophthalmitis associated with exposure of scleral fixation knot. The patient received vitrectomy and intravitreal injection of antibiotics and vitreous culture. After 2 days, IOL removal, silicone oil tamponade and intravitreal injection of antibiotics were performed due to uncontrolled inflammation with accompanying hypopyon. Hemophilus influenza was isolated in the vitreous sample. Removal of silicone oil was performed at 1 month. There was no recurrent inflammation at 1 year and she received scleral fixation of IOL for the second time. At 1 year and 3 months, corrected visual acuity was 0.4 without signs of inflammation. CONCLUSIONS: In cases of exposed scleral fixation knot after IOL insertion, a risk of endophthalmitis exists. Meticulous care is required when fixation knot is exposed due to thinning of overlying conjunctiva. |
| Key Words:
Endophthalmitis;Scleral fixation;Suture erosion |
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