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Stenotrophomonas maltophilia endophthalmitis after intraocular lens implantation

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Stenotrophomonas maltophilia is an opportunistic, gram-negative bacillus. Endophthalmitis induced by S. maltophilia has not been commonly described after intraocular lens implantation. To report a case of Stenotrophomonas maltophilia endophthalmitis in a patient with borderline diabetes mellitus after intraocular lens implantation.


Vitreoretinal Services, Mediclinic Welcare Hospital, Dubai.


A 68-year-old gentleman with borderline diabetes presented one month after cataract surgery with intraocular lens implantation with symptoms and signs of endophthalmitis. He underwent vitreous tap, pars plana vitrectomy, IOL explantation, removal of capsule with intravitreal vancomycin (1.0mg/0.1ml), ceftazidime (2.25mg/0.1ml) and dexamethasone (0.4/0.1ml). Cultures grew S. maltophilia, which was sensitive to trimethprim -sulbactam and weakly sensitive to moxifloxacin. He was treated with oral bactrim DS, oral and topical moxifloxacin.


Following this treatment, the infection resolved, however he developed ocular hypotony with hypotony maculopathy, which was initially treated with oral steroids. Since the IOP remained persistently low, he underwent 5000cs silicone oil injection. Visual acuity improved from hand motions (at presentation) to 0.1 (final visual acuity).


S. maltophilia is a potential opportunistic intraocular pathogen, and is known to cause acute endophthalmitis with poor prognosis. The combined procedure of intraocular lens explantation and pars plana vitrectomy was useful in resolving this fulminant infection and improving vision.

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