ABSTRACT
We report the case of a female patient in her late 20s who visited the clinic with concerns about poor vision, redness, watering and a burning sensation in her left eye 2 weeks after undergoing a small incision lenticule extraction. She had no history of systemic illness or immunosuppressed status. On slit lamp examination, she was found to have corneal stromal infiltrates in the interface at multiple locations. Given the clinical diagnosis of microbial keratitis, corneal scraping of the interface infiltrate was performed and sent for microbiological examination revealing gram-positive, thin, beaded filaments that were acid-fast positive and later identified by growth in culture media as Nocardia species. This case was managed successfully with the use of topical amikacin and systemic trimethoprim-sulfamethoxazole with complete resolution of infection.
Subject(s)
Anti-Bacterial Agents , Eye Infections, Bacterial , Keratitis , Nocardia Infections , Humans , Female , Nocardia Infections/diagnosis , Nocardia Infections/drug therapy , Keratitis/microbiology , Keratitis/drug therapy , Keratitis/diagnosis , Keratitis/surgery , Anti-Bacterial Agents/therapeutic use , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/microbiology , Eye Infections, Bacterial/drug therapy , Amikacin/therapeutic use , Amikacin/administration & dosage , Adult , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Nocardia/isolation & purification , Surgical Wound Infection/microbiology , Surgical Wound Infection/drug therapy , Surgical Wound Infection/diagnosisABSTRACT
Introduction Cataract being one of the leading causes of avertible blindness has been found to be quite prevalent in developing countries like India. The National Programme for Control of Blindness (NPCB) aims at reducing blindness due to cataract via cataract control programs. The most commonly performed surgery is the manual small incision cataract surgery (MSICS). Aim The aim of this study was to determine the visual acuity and outcome in patients who underwent MSICS in a tertiary hospital in south India. Methodology A prospective longitudinal interventional study was conducted in a tertiary hospital in Karnataka, India, over a period of nine months. A total of 105 eyes underwent MSICS and were followed up for one month to assess their postoperative visual outcome and complications, if any. During this period, they were started on antibiotic + steroid combination eyedrops, which were tapered over four weeks. Results Results were assessed based on visual grading categorized by the World Health Organization (WHO). A total of 103 (98.1%) patients had good vision, i.e., visual acuity of 6/6 - 6/18, followed by two (1.9%) who had moderate vision i.e., visual acuity of <6/18 - 3/60, and none were blind or with visual acuity of <3/60. Complications seen intraoperatively in two patients (1.9%) were iris prolapse and posterior capsular rent, respectively, and postoperatively one (0.95%) patient showed hyphema with inferior haptic in the anterior chamber. Conclusion This study proves that a good visual outcome with a low complication rate can be achieved after MSICS with posterior chamber intraocular lens implantation.
