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Photo Essay
December 2004

Mycobacterium chelonae Wound Ulcer After Clear-CorneaCataract Surgery

Arch Ophthalmol. 2004;122(12):1888-1889. doi:10.1001/archopht.122.12.1888

An 81-year-old woman developed a wound infiltrate 3 weeks after clear-corneacataract surgery in the right eye. Initial improvement with topical ofloxacinand corticosteroid was followed by development of a satellite lesion. On consultation,a corneal infiltrate with a crystalline appearance was seen near the surgicalwound (Figure 1). Acid-fast stain showedacid-fast bacilli (Figure 2) and culturesgrew Mycobacterium chelonae, which is sensitive tothe following (in order of sensitivity, from greatest to least): clarithromycin,ciprofloxacin, tobramycin, and amikacin. The ulcer improved with topical amikacinsulfate and oral clarithromycin. Six weeks after diagnosis, a pars plana vitrectomywas performed for severe vitreous inflammation. Smears and culture of thevitreous body were negative for microorganisms. Two months later, the patientdeveloped iritis, which responded to low-dose topical corticosteroids. Asof this report, the cornea has remained quiet after 1 year of follow-up (Figure 3).