Purpose: To report a case of bilateral Propionibacterium acnes endophthalmitis after extracapsular cataract extraction. Case Report: Male, 56 years old, underwent bilateral no- simultaneous extracapsular cataract extraction in 1998, followed by the second surgery 7 months after the first. Four months after each surgery, an unspecific inflamma- tory response was diagnosed. Almost 1 year after intense topical, peribulbar and systemic steroid treatment, he underwent anterior chamber paracentesis, vitreous and endocapsular puncture, when P. acnes was isolated. A vitrectomy was performed and vancomycin was injected into the vitreous chamber and the anterior chamber of his left eye, whose evolution was pthisis bulbi his right eye was submitted to vitrectomy, vancomycin injection and intraocular lens explantation, recovering a best corrected visual acuity of 20/70. Conclusion: Late bilateral non simultaneous endophthalmitis presentation after cataract extracapsular extraction with intraocular lens implant leads us to a complete clinical and laboratorial investigation facing an active inflammatory response after the first surgery, including microbiological conjunctival cul-de-sac evaluation in order to rule out the possibility of exogenous contamination before the fellow eye can undergo the same surgical procedure.
Endophthalmitis; Propionibacterium acnes; Cataract extraction
