Escherichia coli endophthalmitis after trans-scleral resection of uveal melanoma

PURPOSE. To report a case of Escherichia coli endophthalmitis after trans-scleral resection of an uveal melanoma. METHODS. A large ciliary body melanoma was treated by trans-scleral resection and full-thickness sclerectomy because of epibulbar tumor extrusion, followed by adjuvant ruthenium plaque therapy. RESULTS. Two months after treatment the patient developed wound dehiscence and consecutive endophthalmitis. Cultures of the involved sclera yielded Escherichia coli. The infection resolved after systemic intravenous ciprofloxacin and ceftriaxone, with aggressive topical ciprofloxacin and tobramycin. Final visual acuity was light perception. CONCLUSIONS. We assume that the ruthenium plaque placed over the scleral patch was responsible for the delay in scleral healing, with consequent wound dehiscence and E. coli endophthalmitis.