Role of intrastromal vancomycin in recalcitrant corneal abscess after phacoemulsification

BMJ Case Rep. 2021 May 24;14(5):e241709. doi: 10.1136/bcr-2021-241709.

Abstract

Side port infection and corneal abscess after cataract surgery can produce devastating outcomes. Topical antibacterial drugs are the mainstay in management of these cases. Although intrastromal antifungal agents are an established modality for fungal keratitis, such use of antibacterial agents is rarely reported due to better pharmacokinetic profile of antibacterial agents.We report a case of methicillin-resistant Staphylococcus aureus corneal abscess following phacoemulsification that responded to intrastromal vancomycin injection in addition to conventional therapy.This case of postphacoemulsification corneal abscess highlights the importance of postoperative hygiene practices, use of anterior segment optical coherence tomography for monitoring these patients and use of intrastromal vancomycin as an adjunct to topical and systemic therapy.

Keywords: corneal abscess; intrastromal; phacoemulsification; vancomycin.

Publication types

  • Case Reports

MeSH terms

  • Abscess / drug therapy
  • Abscess / etiology
  • Abscess / surgery
  • Humans
  • Keratitis* / drug therapy
  • Methicillin-Resistant Staphylococcus aureus*
  • Phacoemulsification*
  • Vancomycin

Substances

  • Vancomycin