1/6. Retained lens fragments after phacoemulsification manifesting as marked intraocular inflammation with hypopyon.We reviewed the medical records of four patients with marked intraocular inflammation and hypopyon as the initial manifestation of retained lens fragments after phacoemulsification. The severe inflammatory reaction occurred between one month and one year after the cataract extraction. All four patients underwent pars plana vitrectomy to remove the lens fragments. The vitreous specimens were cultured to rule out infectious endophthalmitis. In all patients, no organisms were isolated from the vitrectomy specimens placed on both aerobic and anaerobic media. All patients had improved vision and resolution of the marked intraocular inflammation after vitrectomy. Echography was useful in establishing the diagnosis in these uncommon cases.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/6. Pericardial infusion of tissue plasminogen activator in fibropurulent pericarditis.A 61-year-old man developed a loculated fibropurulent pericarditis, a rare complication of bacteremia. This occurred as a complication of a Staphylococcal aureus bacteremia from a head and neck abscess following self-extraction of a tooth. Despite surgical intervention and placement of 2 pericardial drains, a refractory, inadequately drained infected pericardial effusion persisted. Although there is limited experience with thrombolytic therapy to dissolve a fibrin clot in the pericardium, break down loculated adhesions, and facilitate free drainage of infected material, lysis is well described in the management of exudative pleural effusions. After infusion of 30 mg of tissue plasminogen activator in 100 cc normal saline through the pericardial drain of the patient, a large amount of infected serosanginous material subsequently drained during the next 2 days. The patient became afebrile and culture negative, remained hemodynamically stable, and had resolution of his pericarditis and pericardial effusion on electrocardiogram and echocardiogram, respectively.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/6. staphylococcus hominis endophthalmitis associated with a capsular hypopyon.PURPOSE: To report a case of staphylococcus hominis endophthalmitis associated with a capsular hypopyon. DESIGN: Interventional case report. methods: A 51-year-old man presented with chronic postcataract extraction inflammation and underwent vitrectomy, partial capsulectomy, and intravitreal antibiotic injections, followed by explantation of the intraocular lens and capsule. RESULTS: A capsular hypopyon in the absence of an anterior chamber hypopyon was noted. Cultures of the vitreous and capsule revealed staphylococcus hominis, a coagulase-negative gram-positive organism. CONCLUSIONS: We are unaware of previous reports of endophthalmitis caused by staphylococcus hominis, and could find none in a computerized search using medline. This case adds staphylococcus hominis to the list of causative organisms in chronic endophthalmitis and illustrates the rare finding of a capsular hypopyon.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/6. Endocapsular hypopyon: a clinical sign of localized endophthalmitis.Chronic intraocular infection following cataract extraction and intraocular lens (IOL) implantation has been documented by several authors. We report a case of chronic, bacterial endophthalmitis that clinically correlates with previous pathologic studies in which the focus of infection was sequestered in the capsular sac between the IOL and the posterior lens capsule. Successful management did not require IOL removal.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/6. Phacoanaphylactic endophthalmitis associated with extracapsular cataract extraction and posterior chamber intraocular lens.We describe the clinicopathologic findings in a patient who underwent extracapsular cataract extraction (ECCE) with insertion of a posterior chamber intraocular lens (IOL). The patient had a sterile hypopyon and anterior uveitis that temporarily subsided but recurred. The inflammation actually worsened after removal of the IOL, and the eye was enucleated. Histopathologic examination showed a pattern consistent with phacoanaphylactic endophthalmitis. We therefore postulate that the patient's complications were due to hypersensitivity to her own lens protein, which remained after the ECCE, rather than to the IOL itself.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
6/6. Hypopyon--an unusual sign in acute angle-closure glaucoma.The appearance of a hypopyon is an extremely uncommon finding in acute angle-closure glaucoma and only a few cases have been previously reported in the literature. We report a fifty-year-old female who, following a recent bereavement, presented with classical features of acute angle-closure glaucoma and a hypopyon. The eye developed a glaukomflecken and the patient underwent trabeculectomy, extracapsular cataract extraction and intraocular lens implantation with good post-operative results. Because hypopyon in acute angle-closure glaucoma is rare and may cause diagnostic confusion and hence therapeutic difficulties, this case is described to highlight this unusual clinical sign.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |