Journal List > J Korean Ophthalmol Soc > v.56(10) > 1010125

Shin, Lee, Kim, and Jo: A Case of Pseudomonas aeruginosa Infection after Scleral Buckling for Retinal Detachment

Abstract

Purpose

To report a case of Pseudomonas aeruginosa infection after scleral buckling for retinal detachment.

Case summary

A 68-year-old male presented with a 2-day history of pain in the right eye. The patient had a history of scleral buckling for retinal detachment 10 years earlier and excisional biopsy for conjunctival mass 1 month previously. Biopsy revealed chronic inflammation and granulation tissue formation. Slit-lamp examinations revealed superior conjunctival injection, edema and exposed suture knot. Fundus examination revealed exudative retinal detachment and choroidal detachment. The conjunctival le-sion did not improve although the patient was treated with moxifloxacin. After 4 days, bacterial and fungal cultures were performed because the conjunctiva presented with purulent discharge 4 days after treatment. The scleral buckle and suture knot were removed. The cultures revealed growth of Pseudomonas aeruginosa. According to antibiotic sensitivity test results, the authors treated the patient with ceftazidime. The conjunctival lesion, choroidal detachment and exudative retinal detachment were improved.

Conclusions

In patients with conjunctival injection, edema, purulent discharge and ocular pain after scleral buckling, presence of infection should be suspected. If scleral buckle infection is suspected, bacterial culture, antibiotics treatment and scleral buck-le removal should be considered.

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Figure 1.
Anterior segment photograph of the right eye show-ing chemosis and injection of the conjunctiva with whitish ele-vated lesions and purulent discharge.
jkos-56-1646f1.tif
Figure 2.
Gross photograph of removed scleral explant. The darkened area is suspected of pseudomonas infection.
jkos-56-1646f2.tif
Figure 3.
Three days after scleral explant removal. Anterior segment photograph shows the melted conjunctiva and visible uveal tissue through the melted sclera.
jkos-56-1646f3.tif
Figure 4.
Three months after scleral explant removal. Anterior segment photograph shows mild conjunctival injection and scleral thinning.
jkos-56-1646f4.tif
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