Post Cataract Research Articles

Surgical Outcome of Traumatic Cataract Following Corneal Perforation in Children in a Tertiary Eye Care Centre in Nepal

Introduction: Traumatic paediatric cataract is challenging and its management is difficult. It is associated with other distortion of ocular anatomy and subsequent post- operative complication poses more problems. It is mostly unilateral. The purpose of this study is to assess the outcome of traumatic cataract following corneal perforation in Nepalese children in a tertiary eye hospital in Nepal.Material and Methods: It was a retrospective review of medical records of children who developed cataract following perforating corneal injuries. The study included 69 cases diagnosed as unilateral traumatic cataract over a period of 70 months (January 2010 till October 2015) at Tilganga Institute of Ophthalmology (TIO). Traumatic cataracts caused by other than the perforating corneal injuries were excluded from the study.Results: Children between 6 to 10 years of age had highest percentage of ocular trauma. Boys were more commonly affected than girls. Forty two percentages of children had visual outcome of better than or equal to 6/18.Poor visual outcome was mainly due to anterior segment pathology- corneal scar (14.49%).Posterior segment pathology like macular scar, vitreous haemorrhage and retinal detachment contributed to 7.34% of the cause.Conclusion: Outcome of the traumatic cataract surgery varied. Visual outcome of post traumatic cataract after corneal perforation was dependent on multiple factors like co- existence of the anterior and posterior segment trauma, per –operative and post-operative challenges. Prompt and good management of traumatic cataract can result in good visual outcome.J Nepal Paediatr Soc 2016;36(1):50-55

Assessment of Cataract Surgery Outcome Using the Modified Catquest Short-Form Instrument in China.

PurposeTo assess cataract surgery outcome using the Rasch scaled Chinese version of the Catquest short-form.MethodsThe Chinese translated and culturally adapted version of the Catquest-9SF was interviewer-administered to patients, pre and post cataract surgery. Rasch analysis was performed on the baseline data to revise the Catquest. For the surgical outcome assessment, we stacked pre- and post-surgical Catquest data to demonstrate improvement in visual function scores and responsiveness of the instrument to cataract surgery.ResultsA total of 247 cataract patients (median age, 70 yrs; male 51.0%) completed the Catquest 9SF at baseline.The Catquest-9SF possessed adequate measurement precision of 2.15. No disordering of response categories were observed and all the items perfectly fit to the Rasch model except item 7 (outfit >1.5). A slight reduction in precision was observed after removing misfitting item 7 (Catquest-8SF-CN), but the precision value was well above the acceptable value of 2.00. Notably, the instrument was well targeted (mean person location 0.30), demonstrated no evidence of multidimensionality and DIF. At 12 months post-surgery, 74 (30%) patients came for follow-up and completed the Catquest. There was a significant improvement in the Catquest scores post cataract surgery with a considerably large effect size.ConclusionThe Catquest-8SF-CN demonstrated promising Rasch based psychometric properties and was highly responsive to cataract surgery.

Fulminant Culture Negative Endophthalmitis as a New Entity, Toxic Posterior Segment Syndrome?

1.1.Purpose: To report an unusual case of sterile versus bacterial endophthalmitis in a post cataract surgery wound leak 1.2.Subject: A 58 year old woman with a past eye medical history of LASIK underwent routine cataract extraction (CE) with lens implant of left eye and presented with a delayed, fulminant endophthalmitis OS on day 19 post CE or 3.5 days after the development of a post-op wound leak. Eye examination OS showed visual acuity (VA) of bare LP. Slit lamp examination revealed an edematous cornea with a 1mm hypopyon. A huge amount of exudate filled the entire posterior segment. 1.3.Results: Patient was treated with intravitreal vancomycin (1mg) and ceftazidime (2mg) and pars plana vitrectomy. Vitreal cultures were negative but initial clinical presentation mimicked a virulentstrep, staph, or pseudomonas endophthalmitis. Her post-operative course showed gradual improvement, reaching baseline VA of 20/30 OS with a normal eye exam. 1.4.Conclusion: Although culture negative bacterial endophthalmitis is common, good visual outcomes with virulent bacteria is not. Fulminant culture negative endophthalmitis with a good visual outcome may be due to a sterile toxic insult, a variation of TASS which we call Toxic Posterior Segment Syndrome (TPSS).

A Review of Antibiotic Prophylaxis for Post-operative Endophthalmitis

The purpose of this review is to summarise all available evidence regarding antibiotic prophylaxis for post cataract surgery endophthalmitis as some prophylactic measures add significantly to the cost of surgery, are routinely used and yet their benefit to cataract patients has not been proven. Use of Povidone Iodine before starting the surgery is one of the most effective means of reducing the incidence of postoperative endophthalmitis. Intracameral cefuroxime is another important measure advocated by many studies. Intracameral moxifloxacin may be considered as an alternative to cefuroxime. Although pre and post-operative systemic or topical antibiotics, subconjunctival antibiotics and antibiotics in the irrigating solution have not been proven to decrease post-operative endophthalmitis, they have not been shown to be detrimental and hence surgeons may consider their use according to personal preferences and a costbenefit analysis of their healthcare system.

A comparative study of various topical nonsteroidal anti-inflammatory drugs to steroid drops for control of post cataract surgery inflammation.

Background:Postoperative inflammation continues to be a cause of patient discomfort, delayed recovery, and in some cases, suboptimal visual results. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) and steroid are commonly used in the management and prevention of noninfectious ocular inflammation following cataract surgery.Aims:The aim was to study the safety and efficacy of various NSAIDs drops for control of postoperative inflammation following cataract surgery and compare with steroid eye drops in a patient following cataract surgery.Subjects and Methods:Totally, 200 patients undergoing phacoemulsification with posterior chamber intraocular lens implantation were randomly assigned to receive either nepafenac 0.1% 3 times daily, bromfenac 0.09% twice daily, ketorolac 0.5% 4 times daily for 1 month or 1% prednisolone eye drops as their postoperative anti-inflammatory medication with 50 cases in each group. The patients were examined at the 1st day (baseline), 1st week, 2nd week, and 4th week after surgery. Postoperative inflammation was evaluated subjectively by intraocular pressure, slit-lamp assessment of signs of inflammation, including conjunctival hyperemia, ocular pain, and aqueous cells and flare.Statistical Analysis:Statistical analysis was performed by the SPSS program for Windows, version 17.0.Results and Conclusions:In our study, we found that prednisolone 1% was more effective in controlling postoperative intraocular inflammation in terms of reducing anterior chamber cells and flare. We found that ketorolac 0.5% and nepafenac 0.1% were equally effective in controlling postoperative ocular pain and inflammation. All four drugs are effective in controlling post cataract surgery ocular inflammation. Intraocular inflammation is best controlled with prednisolone 1%, while ocular pain and hyperemia are better controlled with NSAIDs in the early postoperative periods.

Comparison of safety of loteprednol 0.5%/ difluprednate 0.05%/ prednisolone1% eye drops in the post cataract surgery patients

Background: Post surgical ocular inflammation is a common happening after the cataract surgery. Topical steroids are the main stay of the treatment. Although it is quite effective in controlling it but it produces severe adverse drug reactions i.e. rise in intraocular pressure and dryness in the eyes. In present study we have compared the two newer topical steroids i.e. loteprednol and difluprednate with prednisolone for the safety issue. Methods: Total n=150 patients of cataract were enrolled in the study. Institutional ethics committee approval was taken. After randomization, patients were allocated into three groups of 50 each. Baseline reading of intraocular pressure and tear film breakup time was recorded. Post operatively examination was done on day 7, 15 and 30 day. The results were compared as prednisolone versus loteprednol, prednisolone versus difluprednate. Results: A. On intraocular pressure 1.prednisolone versus difluprednate statistically significant effect at day 7 (p=0.043), day15 (p=0.010) and at day 30(p=0.036) were there. 2. Prednisolone versus loteprednol- The difference was statistically highly significant at day 7 (0.00), day 15 (p=0.009) and at day 30 th (p=0.00). B. On tear film breakup time-No significant effect on tear film breakup time is observed. Conclusions: Both the newer drugs are much safer as compared to prednisolone for intraocular pressure. As they are equiefficacious to prednisolone their use in post cataract surgery inflammation is recommended.

To compare the efficacy and preserved/preservative free nepafenac eye drops in the post cataract inflammation patients

Background: Nepafenac is a novel topical NSAID used to treat post operative ocular inflammation and pain. Benzylkonium chloride is used as preservative in the formulation, is notorious in causing ocular surface defect. Now a day, preservative free formulation is available. This study is the comparison of the efficacy and safety of preservative free nepafenac with standard nepafenac eye drop formulation. Methods: This is a prospective investigator masked randomised parallel trial. Total n= 104 patients were enrolled. After randomization, patients were divided into two groups (nepafenac with\without preservative drug).Patients were examined preoperatively (day-1) and post operatively on days 1, 3, 5, 7, 15 and 30 days. The signs of inflammation and tear film break up time were recorded. Results: preservative free nepafenac was found better at certain points like aqueous cells at day15 (p=0.02), conjunctival hyperemia at day 5 (p=0.009) and pain at day3 (p=0.004) at other points. Effect on tear film breakup time was recorded but it is not statistically significant. Conclusions: preservative free nepafenac is found effective in controlling the ocular post inflammation. For evaluating the effect on dryness of eye we need longer trials. Preservative free nepafenac should be preferred over the nepafenac eye drops.

Clinical Features and Risk Factors of Patients with Presumed Ocular Toxoplasmosis.

Purpose:To determine the clinical features and risk factors of presumed ocular toxoplasmosis (POT) in patients affected with the condition at Irrua, Nigeria.Methods:The study included 69 patients with POT, and 69 age and sex matched subjects who served as the control group. Data was obtained using interviewer administered questionnaires. Examination included measurement of visual acuity (VA), intraocular pressure (IOP), slit lamp examination, gonioscopy and dilated fundus examination.Results:Mean age of cases and control subjects was 57.16 ± 18.69 and 56.09 ± 16.01 years respectively. The peak age group in patients with POT was 60 years and above. The most common presenting complaint was blurred vision occurring in 100% of cases. Drinking unfiltered water in 58 (84.1%) patients was the most common risk factor. Other risk factors included post cataract surgery status in 32 (46.4%) subjects, ingestion of poorly cooked meat in 30 (43.5%) cases and exposure to cats in 9 (13.0%) patients. All risk factors were more common in POT patients (P < 0.05). Out of 69 patients, 62 (89.9%) had unilateral while 7 (10.1%) had bilateral involvement. Out of 76 eyes with uveitis, 53 (69.7%) were blind. Active disease was significantly more common with increasing age (P < 0.05).Conclusion:Patients with POT were rather old and some risk factors were modifiable, therefore health education for preventing the transmission of toxoplasmosis and provision of sanitary water may help reduce the incidence of ocular toxoplasmosis.

Surface modification of intraocular lenses towards controlled drug delivery

PurposeOcular drug delivery systems replacing or complementing the usual therapeutics after cataract surgery have been the focus of several studies. A possible solution could be implanting intra‐ocular lenses (IOLs) also acting as drug carriers. The main challenge is to obtain IOLs that besides providing the best refractive outcome release the drug at a suitable rate. The purpose of our research was to design an effective strategy to incorporate the drug and study the release profile.MethodsIOL surface was modified with PHEMA [poly(2‐hydroxyethyl methacrylate)] by treatment with argon plasma and subsequent immersion in a HEMA solution with moxifloxacin (MFX; Vigamox®), followed by a final immersion in an MFX solution. Drug release profiles were obtained in vitro under hydrodynamic conditions, which simulate those found in the eye for the aqueous humor. A microfluidic cell with a volume of 250 μL was designed and used with a continuous flow of saline solution, at 37°C, with a renovation rate similar to the physiological one.ResultsResults showed that MFX was released with concentrations above the minimum inhibitory concentrations for S. aureus, S. epidermidis and S. pneumoniae for 11 days.ConclusionsIn the conditions described, IOLs surface modification with PHEMA has allowed an extended drug release effective to prevent post cataract surgery endophthalmitis.

Effect of Preconditioning Intraocular Lenses in Moxifloxacin Solution

PurposeThe goal of our research was to investigate the possibility of using drug loaded intra‐ocular lenses (IOLs) as an alternative to topical antibiotic usually prescribed after cataract surgery.MethodsAlthough widely used in drug release studies due to its simplicity in comparing systems, static conditions are far from reproducing biological conditions. A microfluidic cell mimetizing chamber's aqueous humor hydrodynamic is a much closer approach. With a volume of 250 µL, the cell is fed with a continuous flow of saline solution at a physiological similar rate.ResultsResults showed that 30 days preconditioned IOLs were able to maintain a MXF concentration above the minimum inhibitory concentrations for Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus pneumoniae for 20 days.ConclusionsFurther investigation in using moxifloxacin loaded IOls as effective to prevent post cataract surgery endophthalmitis is encouraged.

Filamentous fungal endophthalmitis: results of combination therapy with intravitreal amphotericin B and voriconazole.

PurposeTo report outcomes of exogenous fungal endophthalmitis treated with combination of intravitreal antifungal agents.DesignRetrospective, non-randomized, interventional, consecutive case series.MethodsTwelve eyes of twelve consecutive cases of filamentous fungal endophthalmitis were treated with a combination of intravitreal amphotericin-B and intravitreal voriconazole (AmB-Vo Regime) along with pars plana vitrectomy at a single center. Clinical characteristics, microbiology results, treatment strategy, visual, and anatomical outcomes were analyzed.ResultsTen cases out of the twelve were postoperative endophthalmitis of which nine were part of a post cataract surgery cluster. The remaining included endophthalmitis following keratitis post pterygium excision (1) and following open globe injury (2). The most common fungus was Aspergillus terreus, which was isolated in 8/12, followed by A. flavus in 2/12 and Fusarium solani in 1/12. The presenting visual acuity ranged from light perception (LP) to counting fingers. The visual acuity at final follow-up was 20/400 or better in 7/12 eyes (58.33%) and 20/60 in 2/12 eyes (range 20/60 to LP). All eyes with corneal involvement had final visual acuity 20/400 or worse. Globe salvage was achieved in all cases.ConclusionCombining intravitreal amphotericin-B and voriconazole could be a novel treatment strategy in the management of endophthalmitis caused by filamentous fungus. Eyes with corneal involvement had poor visual outcome either with or without therapeutic penetrating keratoplasty.

English

BACKGROUND: Post-operative endophthalmitis is a most devastating complication of post-cataract surgery. A thorough understanding of clinical signs, symptoms and micro biological aspect is most essential for treatment of endophthalmitis. AIM: To study the etiological agents. Clinical spectrum and final visual outcome after management of post cataract surgery endophthalmitis. MATERIALS AND METHOD: Retrospective study of 166 eyes with post cataract surgery endophthalmitis from1999 to 2005In all cases anterior chamber tap / vitreous tap /biopsy was taken and sent for smear and culture sensitivity. vancomycin amikacin and ceftazidine was injected intravitreally RESULT: 59(35.5%) of 166 cases were smear and culture positive. Nocardia 26(46%) strep Pneumonia (9-13) (23%) staph epidermidis 10(18%) Pseudomonas 7(13%) staph aureus 2 % mixed 1%. CONCLUSION: Post-operative endophthalmitis is a devastating complication following cataract surgery can have a better visual outcome when treated early aggresively and optimistically.

Psoriasis: an eye opener – a cross-sectional study in a Tertiary Care Hospital of South India

Introduction: Psoriasis is a multi-system chronic inflammatory skin disease targeting 2% to 3% of the general population. It is a prototype of immune dysregulation mediated by TH1 proinflammatory cytokines such as TNF-α, IFN-gamma, IL-6, and IL-12 with far reaching systemic effects. There is growing and emerging evidence that psoriasis patients have a higher prevalence of associated comorbid diseases, with severe skin disease portends a serious risk for development of these comorbidities and are found to have a higher association of extracutaneous disease manifestations. Aim: To look for eye involvement in psoriasis patients and to evaluate the risk and prognostic factors of disease association. Material and Methods: 200 Patients with psoriasis were screened for any eye involvement after few unusual case presentations with eye complications during the period from September 2013 - August 2014. Results: First case was a post cataract sudden loss of vision secondary to development of uveitis in a female patient aged 52 years, with past history of psoriasis with minimal skin lesions and no arthritis. Another 5 cases of psoriasis with eye involvement were detected during the screening employed in a series of 200 psoriasis cases. Conclusion: The present report highlights the importance of psoriasis and eye involvement, need for collaboration between dermatologists and ophthalmologists for thorough examination and evaluation prior to any surgical intervention and also further long term follow-up studies are warranted for confirmation of this causal relationship.

Effect of ophthalmic viscosurgical devices on post cataract intra ocular pressure changes and an assessment of their relative protective effect: a randomized controlled study

Background: Manual small incision cataract surgery (MSICS) has emerged as a popular technique in the ophthalmic practice. Ophthalmic viscosurgical devices (OVDs) are an integral part of the modern ophthalmic practice their role came to prominence with the success of extra capsular cataract extraction (ECCE) and the use of intra ocular lens implants (IOLs).There are few published data about the effect of various OVDs following manual small incision cataract surgery. Aims and objective: To determine post operative intra ocular pressure(IOP) changes after MSICS technique upon using OVDs; hydroxy propyl methyl cellulose (HPMC) and sodium hyaluronate (NAH) and also to assess the post operative protective effect of these two OVDs on cornea. Methodology: Sample of 60 senile cataract patients selected from the outpatient department of Ophthalmology and divided into 2 equal groups of 2%HPMC(Group A) and 1%NAH(Group B).MSICS technique was adopted for cataract surgery .Pre and postoperative IOP was assessed using Goldmann applanation tonometer and the cornea was examined under slit lamp Biomicroscope. Data was statistically analyzed using SPSS (statistical package of social sciences) version 16.01. A value of p

Effect of Nursing Intervention Guidelines on Nurses’ Role, Patients’ Needs, and Visual Problems Post Cataract Surgery

In Egypt, cataract is the major cause of blindness of the population aged 65 years or older. Inadequate postoperative nursing care may lead to serious complications for the patient with cataract surgery. The aim of this study was to evaluate the effect of the use of nursing guidelines on nurses’ knowledge and practices and on their achievement of patients’ needs post cataract surgery. This quasi-experimental pre-post assessment study was carried out on 34 nurses working at the outpatient clinics and ophthalmology departments in El Ramad Hospital, Rod El Farag, Cairo, affiliated to Ministry of Health and 34 patients undergoing cataract surgery in the setting. Data collection tools were a self-administered questionnaire and an observation checklist. The researcher developed nursing guidelines based on analysis of the data collected in the assessment phase to provide nurses with guides for care of cataract patients after surgery. The evaluation of the guidelines’ effects on nurses' knowledge and practice, and consequently on patients' needs was carried out immediately after implementation (post-test), and 3 months after (follow-up). The results showed statistically significant improvements in nurses’ knowledge and practice at the post and follow-up tests (p<0.001), with statistically significant strong positive correlation (r=0.714) between them. Also, there were statistically significant improvements in all areas of patient needs after implementation (p<0.001). In multivariate analysis, the intervention was a statistically significant independent positive predictor of the improvement in nurses’ knowledge and practice, and of patients’ needs. In conclusion, implementing nursing guidelines for care of cataract patients after surgery is effective in inducing improvements in nurses’ related knowledge and practice, which better achievement of patients' needs. It is recommended that these guidelines be used in similar settings. Further research is proposed to investigate the effect of the implementation of these guidelines on decreasing the incidence of complications after the surgical technique.

Biomaterials for ocular reconstruction

Synthetic materials have played a significant role in ophthalmic applications to improve vision for many years. This has been in four main areas in ophthalmology: ocular surface reconstruction, lens replacement, vitreous replacement and structural support and cell transplantation in the retina. Corneal replacement therapies have been developed using both synthetic acrylic-based materials and more recently naturally derived materials such as amniotic membrane. Intraocular lenses as a replacement for the natural lens post cataract surgery has been used for many years. Newer developments include the opportunity to use gels so that the lenses can accommodate but these need improving in terms of the cross-linking chemistry. Silicone oils have been used as long-term tamponade agents as vitreous replacements but recent developments in their properties has enhanced the clinical outcomes and further research into their use as drug delivery vehicles will be a major advancement. Regenerative medicine therapies to repopulate the retina to repair and replace specific cell layers require the optimisation of synthetic scaffolds and this is a major area for development. Recent developments in biomaterials have emphasised the importance of the physical, chemical and mechanical properties specific to a particular ophthalmic application. Materials science has a critical role in developing strategies to overcome vision loss.

Patent perspectives for corticosteroids based ophthalmic therapeutics.

Eye inflammation, if untreated at right time poses the risk of vision loss. Several categories of drugs are available in the global market, but corticosteroids are still used for the treatment of ocular inflammation including anterior/ posterior uveitis, age related macular degeneration (AMD) and post cataract surgery inflammation. Although corticosteroids have well-documented side effects as compared to non steroidal anti-inflammatory drugs (NSAIDs), but they are still regarded as better anti-inflammatory agents for treating ocular inflammations. The prime concern with conventional formulations such as (ophthalmic solutions, suspensions, ointments) is low drug bioavailability due to precorneal barrier of the eye, tear turnover and rapid drainage of drug via nasolacrimal drainage and drug induced systemic toxicity. To overcome these limitations, various novel formulations of corticosteroids have been explored. These include nanoparticles, solid lipid nanoparticles (SLN), nanostructured lipid carriers (NLC), nanomicelles, in-situ gels, iontophoresis, liposomes, nanoemulsions, microemulsions and ocular implants for the effective ophthalmic delivery of the corticosteroids. Topical nanocarriers have also been demonstrated to be promising vectors with potential application in the ophthalmic therapeutics. This review summarizes the clinical findings and patents on various corticosteroids as ocular pharmacotherapeutics.

Effect of Intravitreal Moxifloxacin in Acute Post Traumatic Endophthalmitis

We describe results of intravitreal moxifloxacin in a case of acute post traumatic endophthalmitis & cataract developed after sustaining a penetrating ocular injury. Management included topical and intravitreal moxifloxacin. The intravitreal injection was given at the time of presentation and then was repeated after 48 hours when lens aspiration and anterior vitrectomy was performed. The patient showed a rapid recovery, and achieved 6/6 vision following surgery. To our knowledge this is the first reported case of therapeutic use of intravitreal moxifloxacin in a human case of acute post traumatic endophthalmitis. Presentation of Case: We report a case of a twenty one year old male referred to us with two days history of penetrating injury in left eye due to a piece of metallic wire. After five days of hospitalization, he was discharged with 6/6 partial best corrected vision. Consent: The patient and his family have given informed consent for the publication of this case report.

Intravitreal corticosteroids as first‐line adjunctive treatment in acute post cataract surgery endophthalmitis

AbstractPurpose To assess the effect of intravitreal corticosteroids as first‐line adjunctive treatment in acute post cataract surgery endophthalmitis.Methods We conducted a multicenter prospective, randomized, single‐masked study including patients with acute post cataract surgery endophthalmitis. All patients received the initial intravitreal antibiotics (vancomycine 1mg, ceftazidime 2mg) with intravitreal betamethasone (400 μg) in the group 1 but not in the group 2. At day 2, all patients had the same invitreal antibiotics with betamethasone (400 μg). A prompt or deferred vitrectomy could be associated with this treatment if baseline visual acuity was limited to light perception. The primary endpoint was the BCVA (logMAR) and the secondary endpoint was the impact on intraocular pressureResults We report the preliminary results on the first 54 patients;. 24 patients were included in the group 1 and 30 in the group 2. The BCVA was better in the group 1 at 8 days (1.44 ± 0.90 vs 1.90 ± 1.0 logMAR), at one month (0.50 ± 0.69 vs 1.24 ± 1.11 logMAR) and at 3 months (0.52 ± 0.87 vs 0.99 ± 1.13 logMAR). The confidence intervals were overlapping, except at one month, suggesting a statistical significance at this point. There was no difference in both groups considering the intraocular pressure at day 8: 14.13 mmHg (IC 95%: 10.29‐17.97) in the group 1 and 12.52 mmHg (IC 95%: 10.49‐14.55) in the group 2.Conclusion Intravitreal corticosteroids as a first line adjunctive treatment in acute post cataract surgery endophthalmitis seem to accelerate the recovery of visual acuity but do not seem to have an impact on the final functional outcome. These results need to be confirmed by the statistical analysis of the cohort of 100 cases.

Endophthalmitis Caused by Alcaligenes Faecalis: A Case Series

Purpose: To profile the etiology, clinical outcomes and drug sensitivity patterns in endophthalmitis caused by Alcaligenes faecalis.Methods: Retrospective analysis of all the cases of A. faecalis endophthalmitis presenting to tertiary referral care ophthalmic hospital in Eastern India from January 2009 to December 2012 was done.Results: A total of five cases were included in the study. Out of the five cases, one was of endogenous origin and the rest were post cataract surgery. All but one case underwent vitreo-retinal surgical intervention followed by intravitreal antibiotics. Alcaligenes faecalis was isolated in all the cases. Sensitivity to ceftazidime, aminoglycosides and ciprofloxacin was 20%, 60% and 80%, respectively. Two patients attained a final visual acuity of 6/24. One eye became phthisical in due course.Conclusion. Alcaligenes faecalis is a very rare cause of endophthalmitis. Aminoglycosides and fluroquinolones can be considered as main line of treatment.