Zeitschrift für klinische und experimentelle Ophthalmologie
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Cataractogenesis by Subconjunctival Gentamicin Inadvertently Injected into the Vitreous Cavity Following 23-Gauge Transconjunctival Sutureless Vitrectomy

Sun Ho Lee, Tae Wan Kim, Jang Won Heo, Hyeong Gon Yu and Hum Chung

A 35 year-old man underwent a 23-gauge 3-port sutureless vitrectomy for vitreous hemorrhage from Terson's syndrome in both eyes. A very small amount of gentamicin flowed into the vitreal cavity of only the right eye during intraoperative injection with subconjunctival gentamicin at the end of the surgery. Small cotton-wool patches were noted on the retina on day one after surgery, and minute stellate cortical opacities of the lens were noted one week after the surgery. The cortical opacities progressed to make the retina invisible, and phacoemulsification with intraocular lens insertion was conducted. Best-corrected visual acuity was 20/25 in the right eye and 20/28 in the left eye one week after the surgery. Fundus examination, visual field test, and electroretinogram demonstrated no differences between both eyes, with the exception of the aforementioned cotton-wool patches. Inadvertent intravitreal gentamicin injections can cause cataracts as well as retinal toxicities.