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Late Endophthalmitis Associated with Haptic Exposure after an Intrascleral Fixation Yamane Technique

Fermín Silva Cayatopa*, Ana Luisa González Méndez, Robinson Barrientos Ortiz, Sergio Alfredo Sánchez Cueva

A 62-years-old man who underwent cataract surgery coupled with intraocular lens implantation with the Yamane 2-haptic intrascleral fixation technique (ISF IOL) due to a history of blunt ocular trauma, was referred to our department due to pain and vision loss, 8 weeks after his operation. The patient presented visual acuity of light perception of the right eye, conjunctival hyperemia, hypopyon, vitritis, and 2 exposed PMMA flanges throughout the conjunctiva.

Endophthalmitis was diagnosed, followed by urgent treatment with vitreous and anterior chamber puncture and intravitreal injections of antibiotics and steroids. The cultures revealed Staphylococcus epidermidis infection which was resolved in a few weeks; with notable improvement in final visual acuity.

The SF IOL with 2 monoflex PMMA flanges has gained popularity in the last ten years; a rare complication is the extrusion of the rim that can cause endophthalmitis as in this case. Studies evaluating the short- and long-term complications of this technique are warranted.