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—We appreciate the comments and additional references provided by Dr Shin. The differential diagnosis in our two cases included microbial endophthalmitis as well as an exaggerated inflammatory reaction related to panretinal laser endophotocoagulation or to contaminants in the silicone oil. Both patients developed marked anterior chamber fibrin as well as a prominent hypopyon following pars plana vitrectomy, laser endophotocoagulation, and silicone oil injection. Neither of these patients had preoperative rubeosis iridis and neither received iris photocoagulation.A common standard of care in presumed microbial endophthalmitis is to obtain intraocular cultures and administer intraocular and periocular antibiotics and steroids. In reviewing the literature on reported endophthalmitis cases following vitrectomy and silicone oil injection, a consistent observation was made of purulent material in front of or below the silicone oil, as well as severe ocular pain. Although ocular pain did occur in one of our two patients, it was not
Johnson RN, Parel J, Flynn HW, Portugal LM. Transient Hypopyon Following Primary or Adjunct Argon Laser Photocoagulation-Reply. Arch Ophthalmol. 1989;107(11):1566. doi:10.1001/archopht.1989.01070020644009