Successful antibiotic management of Staphylococcus epidermidis endophthalmitis without ICL explantation or vitrectomy.

Abstract

Abstract Purpose: We report a case of successful medical management of subacute endophthalmitis post implantable collamer lens (ICL) culture-positive of Staphylococcus epidermidis. Observations: A 18-year-old female presented with decreased visual acuity in the left eye 20 days after ICL implantation. A diagnosis of postoperative endophthalmitis was made based on examination and ultrasonography. A vitreous tap was taken, and intravitreal antibiotics (vancomycin 1mg/0.1ml and ceftazidime 2 mg/0.1 mL) were administered twice (q72h), and para bulbar injection of triamcinolone acetonide on day 8. The vitreous culture was confirmed for Staphylococcus epidermidis. The endophthalmitis was resolved, and BCVA improved from 6/20 to 12/20 on day 7 and 22/20 on day 38. This is the first successful medical resolution of Staphylococcus epidermidis endophthalmitis without ICL explantation and vitrectomy in the V4c model. Conclusions and importance: In antibiotic therapy, the excellent compliance and close follow-up of this endophthalmitis patient enabled careful postoperative surveillance on the effect of antibiotic therapy, avoiding the removal of the ICL or the loss of the integrity of the eye. The risk of potential infectious endophthalmitis post-ICL surgery should be fully emphasized during preoperative counseling.