Scanning electron microscope of intraocular lens and crystalline lens posterior capsule of endophthalmitis case.

Abstract

Abstract: : Purpose:The observation of the intraocular lens (IOL) of endophthalmitis case is commonly done via electron microscope, but it is rare that scanned along with the crystalline posterior capsule. We would like to present our finding from the examination of both the posterior capsule and IOL from endophthalmitis case. Methods:77 years old male with diabetes mellitus, radiotherapy medical history of esophageal cancer and prostatic carcinoma. Phachoemulsification and aspiration, intraocular lens insertion by vent keratotomy. The operation became the end without a complication. IOL was used SA60AT manufactured by Alcon Ltd. Postoperative visual acuity (20/25) and initial recovery was positive. However 24 hours postoperation, we found visual acuity loss, intraocular pressure, anterior chamber inflammation cell and fibrin elevation. As endophthalmitis was suspected. On the same day, IOL and a crystalline lens posterior capsule was removed and observed them in scanning electron microscope. In addition, Enterococcus faecalis was detected in vitreous, anterior chamber together. Results:We recognized contraction in the crystalline lens posterior capsule recognized contraction, deformation. But the adhesion of bacteria was not recognized. On the other hand, examining the IOL, we found bacteria adhesion to the optics surface as well as haptics area of 1µm or less. Adhesion cutting mark–shaped configuration by end mill was recognized in haptics. End mill is a machine which forms an IOL at the end. Conclusions:Because adhesion of bacteria was not recognized in the crystalline lens posterior capsule, but a lot of bacteria adhesion was recognized in the IOL, it is suspected that the IOL plays a significant role in the proliferation and adhesion of bacteria. In addition, we believe that cutting mark–shaped configuration by end mill had some influence on bacteria adhesion.

Keywords: endophthalmitis • cataract • microscopy: electron microscopy