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Uncommon complication following uneventful Nd:YAG capsulotomy

Ungewöhnliche Komplikation nach ereignisloser Nd:YAG-Kapsulotomie

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Summary

This article reports the development of low grade endophthalmitis following Nd:YAG laser posterior capsulotomy. The patient previously underwent uncomplicated extracapsular cataract extraction with intraocular lens (IOL) insertion and was free of inflammation prior to laser capsulotomy. Anterior vitrectomy with partial capsular bag removal and anterior chamber washout were performed. Samples for cultures were taken and intravitreal antibiotics injected. The patient was managed with topical and systemic antibiotics and steroids. Complete resolution of the inflammation with return of vision to 20/25 was achieved without removal of the intraocular lens or lenticular remnants. The endophthalmitis was responsive to a minimally invasive intervention as well as medicinal therapy including antibiotic agents, and it resolved without any invasive surgical intervention, such as total capsulectomy, IOL exchange or removal and posterior vitrectomy.

Zusammenfassung

In diesem Beitrag wird über die Entwicklung einer Low-grade-Endophthalmitis nach posteriorer Nd:YAG-Laser-Kapsulotomie berichtet. Bei dem Patienten wurde zuvor eine unkomplizierte extrakapsuläre Kataraktextraktion mit Insertion einer Intraokularlinse (IOL) durchgeführt; vor der Laser-Kapsulotomie lag keine Entzündung vor. Es erfolgte eine anteriore Vitrektomie mit partieller Entfernung der Kapseltasche sowie die Ausspülung der vorderen Kammer. Kulturen wurden entnommen und intravitreale Antibiotika injiziert. Der Patient wurde mit topischen und systemischen Antibiotika sowie Steroiden behandelt. Ein kompletter Rückgang der Entzündung mit Wiedererlangung der Sehkraft zu 20/25 wurde ohne Entfernung der Intraokularlinse oder Linsenresten erreicht. Die Endophthalmitis sprach sowohl auf einen minimal-invasive Eingriff als auch auf die medikamentöse Therapie einschließlich Antibiotika an und heilte ab ohne einen invasiven operativen Eingriff, wie z. B. eine totale Kapsulektomie, Austausch der IOL oder Entfernung und posteriore Vitrektomie.

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Fig. 1

Abbreviations

IOL:

Intraocular lens

Nd-YAG:

Neodymium-doped yttrium aluminum garnet

PCO:

Posterior capsular opacification

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Authors and Affiliations

  1. Department of Ophthalmology, University Medical Center Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany

    Ismail Abuallut

  2. Department of Ophthalmology, Jazan University, Jazan, Saudi Arabia

    Ismail Abuallut

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  1. Ismail Abuallut
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Correspondence to Ismail Abuallut.

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I.I. Abuallut has no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

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Abuallut, I. Uncommon complication following uneventful Nd:YAG capsulotomy. Spektrum Augenheilkd. 32, 198–200 (2018). https://doi.org/10.1007/s00717-018-0411-z

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  • DOI: https://doi.org/10.1007/s00717-018-0411-z

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