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 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.