Abstract
<jats:p>Objective. To present a clinical case illustrating the use of vitrectomy in the treatment of acute postoperative endophthalmitis that developed after phacoemulsification of cataracts (PEC) with intraocular lens (IOL) implantation. Methods. Patient S., 75, presented with complaints of gradual deterioration of vision in his left eye, severe redness, and pain in the left eye. These symptoms had been present for 4 days and appeared on the third day after PEC + IOL surgery on his left eye. According to examination data, visual acuity in the left eye (Vis) was 0.1 n/c, intraocular pressure (IOP) (pneumotonometry) was 20 mmHg. Biomicroscopy of the left eye revealed marked mixed injection, mild corneal edema, precipitates on the corneal endothelium, cellular debris in the anterior chamber, a 1 mm hypopyon in the posterior chamber of the MIOL-2 IOL in the correct position, with fibrous deposits, a yellowish-gray pupillary reflex, severe exudation, and vitreous opacification, with the retina not visible. B-mode ophthalmoscanning revealed marked opacities in the vitreous. A diagnosis of acute postoperative endophthalmitis and pseudophakia was made. Due to the severe findings, a decision was made to perform anterior chamber irrigation and subtotal vitrectomy. During the procedure, paracenteses were performed at the 2 and 9 o'clock positions, followed by anterior chamber irrigation. Iris retractors and three 25G ports were placed at the 2, 5, and 10 o'clock positions. Significant exudation was visualized in the vitreous cavity. A central and peripheral vitrectomy was performed. During the surgery, a retinal break was discovered at the 10 o'clock position, and endolaser restrictive coagulation of the break was performed. Silicone oil was injected into the vitreous cavity. The scleral incisions were sealed with interrupted sutures. Results. The surgery was performed without complications. Postoperatively, anti-inflammatory and antibacterial therapy were prescribed. On the first postoperative day: best-corrected visual acuity in the left eye was 0.16, IOP (pneumotonometry) in the left eye was 18 mmHg. No signs of endophthalmitis were detected. The eye was relatively calm, with mild corneal edema, a deep anterior chamber, clear anterior chamber fluid, and the IOL was in the correct central position with a pink pupillary reflex. B-mode ophthalmic ultrasound showed adherent membranes. The silicone oil was removed two months after surgery. Three months after the procedure: uncorrected Visus 0.6 n/c, IOP (pneumotonometry) 17 mmHg. Conclusions. Early diagnosis and timely surgical treatment of postoperative endophthalmitis help reduce the extent of surgical intervention, accelerate visual rehabilitation, and preserve the patient's visual function. Key words: endophthalmitis, phacoemulsification, vitrectomy</jats:p>