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An outbreak of Pseudomonas aeruginosa endophthalmitis following cataract surgery: a case series and lessons learned

Abdulmajeed Al Khathami, Abdullah I Abbas, Amani AlGhramah, Wejdan S. AlGhamdi, A. N. Alolyani, Khaled Ghaith

Journal of Surgical Case Reports, 2025

2 citations

Abstract

Abstract Endophthalmitis is a severe intraocular infection that can cause substantial visual impairment or blindness. Although it is an uncommon post-cataract surgery complication. In this case series, we present a group of patients who underwent surgery on the same day by the same surgeon. Our goal is to investigate the causes of this outbreak, explore the management strategies employed, and derive lessons learned to prevent future occurrences. This case series presents five immunocompetent patients who underwent uncomplicated cataract surgery at a single center and developed acute postoperative endophthalmitis. All patients presented with severe eye pain and decreased vision on the 2nd day post-surgery; one patient presented 15 days later. Following their surgeries, they were prescribed prednisone acetate and moxifloxacin, both to be taken every 2 h. Their visual acuity at presentation was light perception. Immediate vitreous tap and administration of intravitreal antibiotics. Despite these urgent interventions, the outcomes varied among the patients. In the short term, no significant improvement in visual acuity was noted; all patients continued to experience severely limited vision. The long-term consequences were grave: three of the five patients eventually underwent evisceration due to the severity of the infection and persistent inflammation. This underscores the aggressive nature of the infection and the challenges in managing such severe cases of endophthalmitis.…

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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