Propionibacterium Acnes Endophthalmitis Following Transplantation of Contaminated Descemet's Membrane Endothelial Keratoplasty Graft

Overview

Journal Am J Ophthalmol Case Rep

Specialty Ophthalmology

Date 2021 Nov 12

PMID 34765803

Citations 1

Authors

Grayson W Armstrong

Shawn R Lin

Aviram Assidon

Sarkis Soukiasian

Dean Eliott

Ula Jurkunas

Affiliations

Soon will be listed here.

Abstract

Purpose: To report the clinical outcomes of a case of Propionibacterium acnes (P. acnes) endophthalmitis following Descemet's membrane endothelial keratoplasty (DMEK) surgery.

Observations: Transplantation of non-sterile DMEK tissue led to development of a retrolenticular white plaque confirmed through PCR testing to be the result of P. acnes endophthalmitis. Intraocular antimicrobial therapy, surgical scraping of the white plaque, and repeat DMEK tissue transplantation resulted in an excellent visual outcome (20/20).

Conclusion: This is the first reported case of P. acnes endophthalmitis following DMEK surgery. Re-transplantation may be a viable option for DMEK patients who experience post-operative endophthalmitis.

Citing Articles

Visual Recovery and Endothelial Repopulation after DMEK Graft Removal and Vitrectomy for Late Endophthalmitis: A Case Report.

Szalai E, Belin M, Szijarto Z, Csutak A Case Rep Ophthalmol. 2024; 15(1):736-741.

PMID: 39449735 PMC: 11501103. DOI: 10.1159/000541644.

References

Shirodkar A, Pathengay A, Flynn Jr H, Albini T, Berrocal A, Davis J . Delayed- versus acute-onset endophthalmitis after cataract surgery. Am J Ophthalmol. 2011; 153(3):391-398.e2. PMC: 3381653. DOI: 10.1016/j.ajo.2011.08.029. View

Rodriguez-Calvo-de-Mora M, Quilendrino R, Ham L, Liarakos V, van Dijk K, Baydoun L . Clinical outcome of 500 consecutive cases undergoing Descemet's membrane endothelial keratoplasty. Ophthalmology. 2014; 122(3):464-70. DOI: 10.1016/j.ophtha.2014.09.004. View

Schimel A, Miller D, Flynn Jr H . Endophthalmitis isolates and antibiotic susceptibilities: a 10-year review of culture-proven cases. Am J Ophthalmol. 2013; 156(1):50-52.e1. DOI: 10.1016/j.ajo.2013.01.027. View

Schlogl A, Tourtas T, Kruse F, Weller J . Long-term Clinical Outcome After Descemet Membrane Endothelial Keratoplasty. Am J Ophthalmol. 2016; 169:218-226. DOI: 10.1016/j.ajo.2016.07.002. View

Hamzaoglu E, Straiko M, Mayko Z, Sales C, Terry M . The First 100 Eyes of Standardized Descemet Stripping Automated Endothelial Keratoplasty versus Standardized Descemet Membrane Endothelial Keratoplasty. Ophthalmology. 2015; 122(11):2193-9. DOI: 10.1016/j.ophtha.2015.07.003. View

Meisler D, Mandelbaum S . Propionibacterium-associated endophthalmitis after extracapsular cataract extraction. Review of reported cases. Ophthalmology. 1989; 96(1):54-61. DOI: 10.1016/s0161-6420(89)32939-3. View

Aldave A, Stein J, Deramo V, Shah G, Fischer D, Maguire J . Treatment strategies for postoperative Propionibacterium acnes endophthalmitis. Ophthalmology. 1999; 106(12):2395-401. DOI: 10.1016/S0161-6420(99)90546-8. View

Woo J, Ang M, Htoon H, Tan D . Descemet Membrane Endothelial Keratoplasty Versus Descemet Stripping Automated Endothelial Keratoplasty and Penetrating Keratoplasty. Am J Ophthalmol. 2019; 207:288-303. DOI: 10.1016/j.ajo.2019.06.012. View

Chamberlain W, Lin C, Austin A, Schubach N, Clover J, McLeod S . Descemet Endothelial Thickness Comparison Trial: A Randomized Trial Comparing Ultrathin Descemet Stripping Automated Endothelial Keratoplasty with Descemet Membrane Endothelial Keratoplasty. Ophthalmology. 2018; 126(1):19-26. DOI: 10.1016/j.ophtha.2018.05.019. View

10.

Deramo V, Ting T . Treatment of Propionibacterium acnes endophthalmitis. Curr Opin Ophthalmol. 2001; 12(3):225-9. DOI: 10.1097/00055735-200106000-00015. View

11.

Vaziri K, Schwartz S, Kishor K, Flynn Jr H . Endophthalmitis: state of the art. Clin Ophthalmol. 2015; 9:95-108. PMC: 4293922. DOI: 10.2147/OPTH.S76406. View

12.

Melles G, Lander F, Rietveld F . Transplantation of Descemet's membrane carrying viable endothelium through a small scleral incision. Cornea. 2002; 21(4):415-8. DOI: 10.1097/00003226-200205000-00016. View

13.

Anshu A, Price M, Price Jr F . Risk of corneal transplant rejection significantly reduced with Descemet's membrane endothelial keratoplasty. Ophthalmology. 2012; 119(3):536-40. DOI: 10.1016/j.ophtha.2011.09.019. View

14.

Gao Y, Li C, Bu P, Zhang L, Bouchard C . Infectious interface keratitis (IIK) following lamellar keratoplasty: A literature review. Ocul Surf. 2019; 17(4):635-643. DOI: 10.1016/j.jtos.2019.08.001. View

15.

Rahmani S, Eliott D . Postoperative Endophthalmitis: A Review of Risk Factors, Prophylaxis, Incidence, Microbiology, Treatment, and Outcomes. Semin Ophthalmol. 2017; 33(1):95-101. DOI: 10.1080/08820538.2017.1353826. View