Polymyxin B, Colistin, and Sodium Colistimethate

A 67-year-old man presented with decreased vision in the left eye over the previous 2 months. Pseudophakic bullous keratopathy was diagnosed and uneventful Descemet-stripping endothelial keratoplasty performed. On postoperative day 1, the corrected distance visual acuity (CDVA) was light perception with high digital intraocular pressure. The donor lenticule showed edema with cellular infiltration. B-scan ultrasonography was consistent with endophthalmitis. Donor lenticule extraction with therapeutic penetrating keratoplasty, vitreous biopsy, core vitrectomy, and intravitreal antibiotics was performed. The culture demonstrated multidrug-resistant Klebsiella pneumoniae sensitive to colistin only. After multiple interventions for vitritis and glaucoma control, the endophthalmitis resolved. The final CDVA was 20/200.None of the authors has a financial or proprietary interest in any material or method mentioned.