Endophtalmitis associated with flange exposure after a 4-flanged canabrava fixation techique

Abstract

A 101-year-old woman who underwent 4-flanged intrascleral fixation intraocular lens (ISF IOL) technique surgery in her left eye (elsewhere) 6 months prior to her presentation, was referred to our department due to pain and loss of vision for the previous 4 days. The patient presented with left eye visual acuity of hand motion, conjunctival hyperemia, hypopyon, vitritis, and 2 polypropylene flanges exposed throughout the conjunctiva. Endophthalmitis was diagnosed followed by urgent treatment with vitreous and anterior chamber tap, and intravitreal injections of antibiotics and steroids. Cultures revealed Streptococci viridans infection. No further surgical intervention was performed due to patient opposition. The infection resolved within a few weeks; however, phthisis bulbi developed subsequently. ISF IOL with 4 polypropylene flanges has gained popularity. A rare complication of flange extrusion might lead to endophthalmitis. Studies evaluating short- and long-term complications of this technique are warranted.