A 43-year-old man suffered from corneal perforation by a netal fragment in the right eye while using a lawn mower. At presentation, his visual acuity was hand motion in the right eye and 20/20 in the left eye. Anterior segment demonstrated a 3.5-mm full-thickness corneal laceration, fibrin over pupillary margin, and traumatic cataract. Computed tomography demonstrated a high density of metallic fragment in the vitreous cavity. Traumatic endophthalmitis with intraocular foreign body (IOFB) was diagnosed, and emergent operation was immediately performed after 12 hours of ocular injury. Diffuse retinal vasculitis, vitreous opacity, and an intraocular metal fragment were found during vitrectomy (Fig. 1). At the end of surgery, intravitreal injections of vancomycin (1 mg/0.1 mL) and amikacin (0.2 mg/0.1 mL) were performed. Cultures of vitreous fluid revealed gram-negative bacilli identified as Citrobacter koseri, which was sensitive to amikacin and ceftazidime. Because of persistent vitreous inflammation, intravitreal injections of amikacin and dexamethasone were performed on day 4. Three months later, the best-corrected visual acuity was 20/60. Fundus examination showed the resolution of retinal vasculitis (Fig. 2).
展开▼
