Successful treatment of orthodontic-associated traumatic endophthalmitis

PURPOSE: To report successful management of orthodontic-associated traumatic endophthalmitis. DESIGN: Interventional case report. METHODS: A 17-year-old boy developed endophthalmitis after a penetrating corneal injury produced during removal of an orthodontic wire. Treatment included pars plana vitrectomy (PPV) with broad-spectrum intravitreal and systemic antibiotics. RESULTS: Clinical endophthalmitis resolved after PPV with injection of intravitreal vancomycin (1 mg) and ceftazidime (2.25 mg), along with oral ciprofloxacin (750 mg twice daily). Microbiologic cultures of intraocular samples produced Staphylococcus epidermidis, Streptococcus viridans, and Lactobacillus species. Visual acuity improved to 20/20. CONCLUSIONS: Orthodontic-associated endophthalmitis can involve multiple organisms. It can be successfully treated with current treatment modalities, including PPV, intravitreal antibiotics, and systemic antibiotics.