PMID: 19920631Feb 1, 1995Paper

Delayed-onset pneumococcal endophthalmitis after mitomycin-C trabeculectomy: association with cryptic nasolacrimal obstruction

Journal of Glaucoma
P A SidotiD K Heuer

Abstract

Delayed-onset endophthalmitis is a well-recognized complication of glaucoma filtering surgery, but, to our knowledge, no previous reports have associated this entity with occult nasolacrimal duct obstruction. A 16-month-old girl developed endophthalmitis 1 month after a mitomycin-C trabeculectomy for congenital glaucoma. A diagnostic pars plana vitrectomy, anterior chamber paracentesis, and injection of intravitreal antibiotics were performed. Streptococcus pneumoniae was cultured from the aqueous and vitreous samples. Gradual clearing of the infection was achieved with systemic, intravitreal, and topical antibiotic therapy. Examination following resolution of the infection revealed complete obstruction of the ipsilateral nasolacrimal duct. The high incidence of Streptococcus pneumoniae as the causative organism in delayed-onset endophthalmitis following glaucoma filtering surgery may be related, in part, to preexisting lacrimal outflow obstruction. Careful preoperative evaluation with attention to lacrimal outflow disorders is imperative prior to glaucoma filtering surgery, especially in children.

Citations

Feb 5, 1999·American Journal of Ophthalmology·J A EnglertT A Cox
Apr 30, 1999·Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus·S F FreedmanT A Cox
Oct 15, 2013·Clinical & Experimental Ophthalmology·Jonathan K KamAnne M V Brooks
Aug 8, 2015·Acta Ophthalmologica·Sanaa A Yassin

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