Endophtalmie chronique après chirurgie de la cataracte

Delayed postoperative endophthalmitis following cataract surgery remains a rare complication. We report two cases of patients who presented with marked intraocular inflammation following uncomplicated cataract surgery. The patients did well for the first weeks after surgery (6 and 5 weeks). Both patients presented with visual impairment, inflammatory red eye, and a whitish plaque on the anterior surface of intraocular lenses. Posterior segment examination was normal in both cases. The two patients were treated with systemic antibiotic therapy as well as intravitreal and/or intracameral injections of antibiotics. The exact organism involved could not be identified in either patient. Each patient regained a final 20/25 visual acuity. Based on the clinical courses of these patients, the various possible therapeutic approaches for delayed postoperative endophthalmitis are discussed. This report underlines the problem of reaching the differential diagnosis between inflammation recurrence and delayed postoperative endophthalmitis as well as obtaining positive culture results if the latter diagnosis is suspected.