Ischemic Retinal Vasculitis Associated with Cataract Surgery and Intracameral Vancomycin.

Lucas T Lenci,Christi Carter,Eric K Chin,David R P Almeida,Stephen R Russell

doi:10.1155/2015/683194

Abstract

Recently, there have been reports suggesting that intracameral vancomycin has been associated with retinal vasculitis; some have described this phenomenon as postoperative hemorrhagic occlusive retinal vasculitis. We present a case of a 65-year-old woman who underwent uncomplicated phacoemulsification and posterior chamber intraocular lens implantation followed by intracameral antibiotic prophylaxis. Unlike prior reports, this report demonstrates a case of mild visual reduction and minimal inflammation with subtle but complete unilateral peripheral retinal ischemia associated with cataract surgery and intracameral vancomycin, suggesting a spectrum of toxicity that may be underrecognized.

Highlights

Cataract surgery may be associated with postoperative inflammatory or infectious complications, such as toxic anterior segment syndrome (TASS) or endophthalmitis
We present a case of mild visual reduction and minimal inflammation with subtle but complete unilateral peripheral retinal ischemia associated with cataract surgery and intracameral vancomycin, suggesting a spectrum of toxicity that may be underrecognized
We present a case of ischemic retinal vasculitis associated with intraoperative intracameral vancomycin during cataract surgery

Summary

Introduction

Cataract surgery may be associated with postoperative inflammatory or infectious complications, such as toxic anterior segment syndrome (TASS) or endophthalmitis. TASS or endophthalmitis is heralded by a disproportionate reduction in vision or increase in inflammation. Prior cases reported to be retinal vasculitis associated with cataract surgery and intracameral vancomycin injection showed similar reduction in vision with marked inflammation [1, 2]. We present a case of mild visual reduction and minimal inflammation with subtle but complete unilateral peripheral retinal ischemia associated with cataract surgery and intracameral vancomycin, suggesting a spectrum of toxicity that may be underrecognized

Case Report

Discussion

Conflict of Interests