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Case report
Bleb-related tuberculous endophthalmitis following combined phacoemulsification and trabeculectomy with mitomycin C
  1. Praveen Kumar Seth1,
  2. Savitri Sharma2 and
  3. Sirisha Senthil1
  1. 1Glaucoma, LV Prasad Eye Institute, Hyderabad, Telangana, India
  2. 2Jhaveri Microbiology Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
  1. Correspondence to Dr Sirisha Senthil; sirishasenthil{at}lvpei.org

Abstract

A one-eyed 67-year-old man with 20/400 vision, dense cataract, previously failed trabeculectomy and medically uncontrolled advanced glaucoma underwent a single-site phacoemulsification with repeat trabeculectomy and mitomycin C. One-week postoperatively, vision in the right eye improved to 20/120, good bleb and intraocular pressure (IOP) of 14 mm Hg. By third postoperative week, patient presented to the emergency with diminished vision, pain and redness in right eye of 2 days duration and was diagnosed to have bleb-related endophthalmitis (BRE). Vitreous biopsy, smear from the bleb were taken and underwent pars plana vitrectomy with intraocular antibiotic injection. Smears and cultures were negative however, aqueous DNA-PCR was positive for Mycobacterium tuberculosis. Revisited history revealed treated pulmonary tuberculosis 3 years ago with a positive Mantoux test (17 mm) and hilar prominence on chest X-ray. One month after starting anti-tubercular therapy (ATT), the BRE resolved and vision improved to 20/60 with IOP of 14 mm Hg and the ATT was continued.

  • eye
  • infections
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Footnotes

  • Contributors PKS contributed in conception, design, acquisition, interpretation, drafting the manuscript and critically revising it. SS and SS in interpretation of data, writing the manuscript, revising it critically for important intellectual content to get the article published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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