摘要
BACKGROUND Achromobacter species-associated endophthalmitis is rare and may present as either acute or chronic postoperative endophthalmitis.Delayed-onset Achromobacter species endophthalmitis appearing in acute presentation that develops more than several months after cataract surgery is very rare.Intraocular lens(IOL)removal is commonly recommended to treat Achromobacter species endophthalmitis,which is based on previous studies.Here,we report the results of surgery without IOL removal when treating patients with delayed-onset postoperative Achromobacter species endophthalmitis that developed in an acute form.CASE SUMMARY Three patients visited our ophthalmology clinic due to visual impairment that began 2-3 d earlier.They had undergone cataract surgery 5-18 mo prior.Bestcorrected visual acuity of the diseased eye was between counting fingers at 30 cm to non-light perception.They showed conjunctival injection,inflammation in the anterior chamber(cell reaction 4+)and hypopyon formation.The patients were diagnosed with infectious endophthalmitis and immediately underwent pars plana vitrectomy,anterior chamber irrigation and intravitreal injection of ceftazidime and vancomycin.Before fluid infusion,a vitreous specimen was obtained. In all cases, the IOLs were not removed. Achromobacter species was detected on vitreousspecimen culture. After surgery, the vitreous opacity decreased gradually and there was littleretinal damage. At 1 mo after treatment, the best-corrected visual acuity had improved to 20/50and 20/40.CONCLUSIONDelayed onset postoperative endophthalmitis caused by Achromobacter species can appear in anacute form. All patients responded well to early vitrectomy and administration of empiricalantibiotics including ceftazidime. There was no need for IOL removal during surgery.
