Endophthalmitis following cataract surgery in diabetic patients

Background. Endophthalmitis post cataract surgery is rare, but the incidence and complications are higher in diabetics.

Objectives. We present 3 diabetic patients who underwent cataract surgery and developed endophthalmitis postoperatively.

Material and methods. This is a retrospective case series of diabetic patients who underwent cataract surgery and developed endophthalmitis postoperatively between September 2015 and August 2016. The medical records were retrieved from the system, and data was collected.

Results. The patients eventually had different visual outcomes depending on the severity of endophthalmitis. Case 1. The patient developed delayed subtle postoperative endophthalmitis at 8 weeks post cataract operation, with underlying foot cellulitis and poor blood sugar control. The patient responded well to topical and systemic antibiotics and stabilization of blood sugar. Case 2. The patient presented with delayed postoperative endophthalmitis secondary to a suture abscess of the cataract wound at 7 months post implantation of an anterior chamber intraocular lens. There was complete resolution of the infection after administration of topical, intravitreal and systemic antibiotics, with a good control of blood sugar. Case 3. The patient presented with acute severe postoperative endophthalmitis with the presence of hypopyon at day 5 following cataract surgery. There were no obvious risk factors besides poor control of blood sugar, but Streptococcus mitis was isolated from the vitreous specimen. The endophthalmitis worsened in spite of topical, intravitreal and systemic antibiotics, as well as vitrectomy. Evisceration was eventually performed for the painful blind eye.

Conclusions. Although endophthalmitis following cataract surgery is rare, the incidence and complications are much higher in diabetic patients.