Endophthalmitis after corneal suture removal

Introduction: To report 2 patients with acute-onset endophthalmitis after intraocular lens exchange and delayed corneal suture removal. Patient and Clinical Findings: An 83-year-old woman and a 64-year-old man developed pain, decreased vision, corneal infiltrate, marked intraocular inflammation, and vitreous membranes after corneal suture removal. Topical povidone–iodine was not used before suture removal, and the wounds showed negative results for Seidel test at presentation. Diagnosis, Intervention, Outcomes: Both patients were diagnosed with acute-onset endophthalmitis. One received vitreous tap and injection (T&I) and the other received both T&I and pars plana vitrectomy. Intravitreal vancomycin and ceftazidime were administered in both patients. Cultures demonstrated streptococcal species. Outcomes were poor: 1 eye was enucleated and the other showed light perception. Conclusions: Endophthalmitis in the setting of corneal suture removal can be associated with severe vision loss. Topical povidone–iodine antisepsis and topical antibiotics should be considered for endophthalmitis prophylaxis in this procedure.