Successful re-implantation of implantable collamer lens after management of post-ICL methicillin-resistant Staphylococcus epidermidis endophthalmitis

BMJ Case Rep. 2015 Nov 24:2015:bcr2015212708. doi: 10.1136/bcr-2015-212708.

Abstract

A 29-year-old man presented with acute onset pain, redness and diminution of vision in the right eye 5 days after implantation of an implantable collamer lens (ICL). A diagnosis of postoperative endophthalmitis was made based on examination and ultrasonography. A vitreous tap was taken and intravitreal antibiotics (vancomycin 1 mg/0.1 ml+piperacillin-tazobactam 225 µg/0.1 mL) were administered. The vitreous culture revealed presence of methicillin-resistant Staphylococcus epidermidis. There was minimal improvement after 48 h; hence the ICL was explanted and repeat injection of intravitreal antibiotics administered. Following this, the endophthalmitis resolved and the patient achieved a corrected distance visual acuity of 20/25 4 weeks later. A repeat implantation of ICL was performed 9 months after the first surgery, following which the patient regained uncorrected distance visual acuity of 20/20. To our knowledge, this is the first case in which an ICL was re-implanted after successful resolution of endophthalmitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Endophthalmitis / drug therapy*
  • Humans
  • Lens Implantation, Intraocular*
  • Lenses, Intraocular
  • Male
  • Methicillin-Resistant Staphylococcus aureus*
  • Postoperative Complications / drug therapy
  • Postoperative Complications / microbiology*
  • Reoperation
  • Staphylococcal Infections / drug therapy*
  • Staphylococcus epidermidis*

Substances

  • Anti-Bacterial Agents