Acute infectious endophthalmitis after chandelier-assisted scleral buckling surgery.

Purpose: To report a rare case of acute bacterial endophthalmitis that developed after scleral buckling surgery performed with non-contact wide-angle viewing system (WAVS) and chandelier endoillumination.

Case description: A 63-year-old man underwent scleral buckling surgery using a WAVS with chandelier endoillumination for rhegmatogenous retinal detachment repair in his left eye. Seven days after the surgery, the patient noticed a marked decrease in his vision with ocular pain. No anterior chamber inflammation or exudates were found. No focal congestion or exudates were noted at the sclerotomy site. Posterior segment examination revealed severe vitreous haze and yellowish exudates in the vitreous cavity. Ocular ultrasound revealed dense vitritis, complete posterior vitreous separation, a fully attached retina, and a peripheral scleral buckle indent. Vitreous biopsy combined with pars plana vitrectomy with intravitreal antibiotic injections was done immediately, and Staphylococcus epidermidis was detected in the vitreous fluid. Following surgery, the inflammation and infection subsided and the visual acuity recovered to 6/9 in 6 weeks.

Conclusion: Infectious endophthalmitis is a rare occurrence after chandelier-assisted scleral buckling (SB) surgery, characterized by ocular pain and a sudden decline in vision as key symptoms. Clinicians should be cognizant of the possibility of its occurrence following SB surgery, especially when utilizing the WAVS with chandelier endoillumination.