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January 1991

Chronic Postoperative Endophthalmitis Associated With Actinomyces Species

Author Affiliations

From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami (Fla) School of Medicine (Dr Roussel and Ms Miller); Ozark Eye Surgeons, Springfield, Mo (Dr Olson); Retina Associates of Cleveland (Ohio) (Dr Rice); and The Cleveland Clinic Foundation (Drs Meisler and Hall). Dr Roussel is now with the Oregon Trail Eye Clinic, Scottsbluff, Neb.

Arch Ophthalmol. 1991;109(1):60-62. doi:10.1001/archopht.1991.01080010062033

Actinomyces species, gram-positive, non—spore-forming anaerobic bacilli were isolated from intraocular fluid obtained from four otherwise healthy patients with a delayed onset of postoperative endophthalmitis. One patient had a mixed anaerobic infection with recovery of both Actinomyces israelii and Propionibacterium acnes. In all four patients, early postoperative visual acuity was good but was eventually markedly reduced by intraocular inflammation that was first observed between 21 days and 4 months following uneventful extracapsular cataract extraction and posterior chamber intraocular lens implantation. Inflammation was characterized by anterior segment and vitreous cellular debris in all cases. All eyes responded to therapy that included intraocular, topical, and systemic antibiotics as well as pars plana vitrectomy and partial iridectomy. These cases further illustrate the need for microbiologic investigation, including anaerobic cultures, in all cases of chronic postoperative inflammation following extracapsular cataract extraction, regardless of the time of onset.