Stenotrophomonas maltophilia Endophthalmitis after cataract extraction.

PURPOSE: To report the clinical course, treatment response, and prognosis of Stenotrophomonas maltophilia endophthalmitis following cataract extraction. METHODS: The clinical records of six cases of S. maltophilia endophthalmitis after cataract extraction were retrospectively reviewed. Data were collected for surgical characteristics, disease course, culture growth, antibiotic sensitivity of the pathogen, response to treatment, and final visual acuity. RESULTS: Four patients underwent uncomplicated cataract extraction with phacoemulsification (PHACO) and intracapsular intraocular lens (IOL) implantation. One case was complicated by inadvertent posterior capsular tear during PHACO and IOL implantation. One patient underwent a combined extracapsular cataract extraction (ECCE) with IOL implantation and trabeculectomy, but vitrectomy was also performed because of cortical material loss into the vitreous cavity after a capsular tear. Symptoms began between postoperative days 1 and 19. All patients underwent a vitreous tap and intravitreal injections of antibiotics. Medical therapy alone was sufficient in five patients to treat the infection. One patient had four episodes of recurrence. Pars plana vitrectomy with subsequent capsulectomy and IOL extraction were performed in this patient to complete remission. CONCLUSION: S. maltophilia should be considered a pathogenic organism possibly causing endophthalmitis after PHACO+IOL implantation. The clinical picture resembles acute bacterial endophthalmitis. When the pathogen has settled in the capsular bag, the infection may persist and become refractory to medical treatment.

Causes of uveitis in a referral hospital in Ankara, Turkey.

PURPOSE: To evaluate the etiology of uveitis and its associated systemic findings in a referral hospital in Ankara, Turkey. MATERIALS AND METHODS: Clinical records of patients in our uveitis department were reviewed retrospectively and 419 eyes of 300 consecutive patients were included in the study. Cases of uveitis due to postoperative endophthalmitis, perforating injuries, and foreign bodies were excluded from the study. The data, including sex, age, clinical presentation, disease course and outcome, ocular involvement, etiology, and associated systemic findings, were entered into a computer database. Pearson chi-square statistical analysis was performed to analyze the data whenever necessary. RESULTS: The study subjects consisted of 162 males and 138 females, with a female to male ratio of 1:1.17 and an average age of 35.7 years. Anterior uveitis was the most common form of uveitis with 43.6%, followed by posterior uveitis (26.6%), panuveitis (20.6%), and intermediate uveitis (9%). Idiopathic uveitis (28.3%) was the most frequent cause of uveitis diagnosed, followed by Behçet's disease (26%) and rheumatic diseases (9%). In 215 (71.7%) out of 300 patients, a specific cause of uveitis with associated systemic findings was identified. Uveitis was attributed to an infectious etiology in only 41 patients (13.6%) of the entire study population. COMMENTS: The etiology of uveitis and its associated systemic findings may vary depending on the geographic distribution of patients and local factors. These results represent those of patients with uveitis referred to hospitals in central Anatolia.