Weak symptoms of bacterial endophthalmitis after a triamcinolone acetonide-assisted pars plana vitrectomy

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Abstract
To report a case of endophthalmitis after triamcinolone acetonide (TA)-assisted par plane vitrectomy (PPV). A 60-year-old Japanese man developed endophthalmitis after TA-assisted PPV for diabetic macular edema. Preoperative visual acuity was 20/200. Four days after surgery, endophthalmitis associated with anterior chamber hypopyon was noticed; the patient’s vision had deteriorated to hand motion. In spite of severe cell infiltration, the ciliary injection and ocular pain were not significant. The additional PPV with irrigation of cefazolin (40 μg/ml) and gentamicin (8 μg/ml) was performed. Endophthalmitis resolved soon after this treatment. Staphylococcus epidermidis was detected in the intravitreous samples. The patient’s visual acuity improved to 20/100. Endophthalmitis may be a complication of TA-assisted PPV with unique signs and symptoms.