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- Rare complication and may occur early or late postoperatively.
- Symptoms: reduced vision, hyperemia, ocular pain or chemosis may be misinterpreted as postoperative inflammatory reaction.
- May present with conjunctival injection and chemosis
- Corneal edema
- Corneal infiltrate or abscess
- Anterior chamber reaction i.e. cells, flare, fibrin or hypopyon, vitritis
- May be complicated with retinal involvement
- Risk factors: organisms from conjunctiva or lids, broken or loose sutures, concomitant anterior vitrectomy, aphakia, previous inflammation or surgery, contaminated donor material (obtained from patients dying from systemic infection / sepsis) or corticosteroid use.
- Thorough ocular examination (day 1 and 1 week postoperatively) for recognizing objective signs of corneal infiltrate, vitreous clouding and/or hypopyon is crucial.
- Early recognition of this complication is very important so that immediate treatment should be initiated and devastating visual consequences could be prevented.
- Broad-spectrum antibiotics such as gentamicin, streptomycin and vancomycin have been routinely added to corneal storage media to help minimizing this postoperative complication.
- Instillation of topical 5% povidone-iodine solution into the cul-de-sac preoperatively.
- Should endophthalmitis be suspected, diagnostic and therapeutic measures have to be performed, including cultures and intravitreal antibiotics.