Early successful treatment of postoperative necrotizing pseudomonas scleritis after trabeculectomy

• Published in: Journal of glaucoma Vol. 6; no. 6; p. 433
• Main Authors: Orengo-Nania, S, Best, S J, Spaeth, G L, Samuelson, T W
• Format: Journal Article
• Language: English
• Published: United States 01.12.1997
• Subjects: Anti-Bacterial Agents; Debridement; Drug Administration Routes; Drug Therapy, Combination - administration & dosage; Eye Infections, Bacterial - etiology; Eye Infections, Bacterial - surgery; Follow-Up Studies; Glaucoma, Open-Angle - surgery; Humans; Male; Middle Aged; Postoperative Complications - etiology; Postoperative Complications - surgery; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - etiology; Pseudomonas Infections - surgery; Reconstructive Surgical Procedures; Sclera - microbiology; Sclera - transplantation; Scleritis - microbiology; Scleritis - surgery; Surgical Wound Infection - microbiology; Surgical Wound Infection - surgery; Trabeculectomy - adverse effects; Visual Acuity
• ISSN: 1057-0829; 1536-481X
• DOI: 10.1097/00061198-199712000-00015

The authors describe a patient who developed pseudomonas scleritis after a routine trabeculectomy. The patient underwent trabeculectomy for poorly controlled intraocular pressure and progressive visual field loss. On the second postoperative date he developed severe pain, significant anterior chamber reaction, and hypotony. Scleral cultures taken at the time of surgical choroidal drainage grew pseudomonas aeruginosa. Surgical reconstruction of the necrotic scleral area and intensive antibiotic treatment lead to a successful outcome. Early recognition and aggressive treatment with antibiotics initially, followed by surgical debridement of necrotic tissue, resulted in an unexpected successful outcome in a patient with pseudomonas scleritis.