The Treatment Process and Clinical Analysis of 2 Cases of Enterococcus Faecalis Infection Following Cataract Surgery

Purpose: To report the clinical diagnosis and treatment of 2 cases of endophthalmitis caused by Enterococcus faecalis following cataract surgery. Methods: Two elderly patients (aged 69 and 87 years) who developed postoperative endophthalmitis after cataract extraction underwent emergency vitrectomy, anterior chamber irrigation, and intravitreal vancomycin injection. Aqueous humor and vitreous fluid samples were collected for bacterial culture and antimicrobial susceptibility testing. Results: Both patients required repeat irrigation due to persistent vitreous opacity. Bacterial culture of vitreous fluid confirmed Enterococcus faecalis (Group D) infection, which was sensitive to vancomycin, penicillin G, levofloxacin, and tigecycline. Post-treatment visual acuity improved to 0.5 (Case 1 at 3 months) and 0.1 (Case 2 at 1 month), respectively. Conclusion: These 2 cases suggest that early vitrectomy combined with intravitreal vancomycin may be an effective treatment for postoperative Enterococcus faecalis endophthalmitis. However, due to the small sample size, these findings should be interpreted with caution. Vitreous fluid culture appears more reliable than aqueous humor culture for pathogen identification.