Multidrug-Resistant Staphylococcus Hominis Endophthalmitis After Cataract Surgery: A Case Report
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT118 | Type: Case Report | DOI: 10.82333/fw22-z178
Authors: Dr Anastasia Tsiogka* 1 , Dr Vasileios Papastavrou 1 , Dr Evripidis Sykakis 2 , Dr Athina Droulia 1 , Mrs Foteini Gyftaki 1
1Ophthalmology,Evgenideio Hospital,Athens,Greece, 2Department of Anterior segment & Glaucoma,Eye Day Clinic,Athens,Greece;Ophthalmology,Emmetropia Mediterranean Eye Institute,Heraklion,Greece
Purpose
To report a case of early postoperative endophthalmitis caused by multidrug-resistant Staphylococcus hominis following uncomplicated cataract surgery, and to highlight the importance of early surgical intervention and culture-guided management in achieving favorable visual outcomes.
Setting
Tertiary care ophthalmology center.
Report of case
A 52-year-old man underwent uneventful phacoemulsification for posterior subcapsular cataract. On postoperative day 1, best-corrected visual acuity (BCVA) was 8/10. Mild intraocular inflammation developed gradually without classic features of acute endophthalmitis. By postoperative day 5, visual acuity declined to 1/10, with marked anterior chamber reaction and clinical suspicion of endophthalmitis.
Urgent pars plana vitrectomy was performed, and intravitreal vancomycin and ceftazidime were administered empirically. Vitreous culture revealed Staphylococcus hominis resistant to most commonly used antibiotics but sensitive to gentamicin. Treatment was adjusted accordingly to include topical gentamicin and oral doxycycline, with close daily monitoring.
One month postoperatively, the patient developed cystoid macular edema, which was successfully managed with oral acetazolamide, topical corticosteroids, and bromfenac. At three months, BCVA improved to 9/10, with no permanent structural damage.
Conclusion/Take home message
Postoperative endophthalmitis due to multidrug-resistant organisms may present atypically and progress rapidly. Prompt vitrectomy, microbiological diagnosis, and tailored antibiotic therapy are critical for preserving vision. Early recognition and intensive follow-up can result in excellent anatomical and functional outcomes even in challenging cases.