DR. DEEPALI SINGHAL

DR.PRAFULLA KUMAR MAHARANA, DR.NAVAROSH JAYARAMAN

Abstract

A 74-year-old woman underwent OD DSAEK for pseudophakic bullous keratopathy following complicated phacoemulsification with ACIOL implantation. The surgery was uneventful with a well-attached graft and visual acuity of 1/60 on day one post-op. On day two, she developed symptoms and signs suggestive of graft infection with endophthalmitis and the patient underwent therapeutic penetrating keratoplasty with core vitrectomy with intravitreal antibiotics. Cultures of donor corneal rim were positive for MDR Pseudomonas aeruginosa sensitive only to polymixin-B. Complete resolution was seen at 3 weeks with 2 doses of intravitreal colistin (1000 IU/0.1 ml). Endophthalmitis following DSAEK can also occur due to bacterial organisms; though the literature mainly focuses on fungal etiology. A positive donor rim may provide a clue regarding the causative organism and the antimicrobial to be used. Intravitreal colistin is useful in MDR Pseudomonas endophthalmitis following DSAEK.