Intracameral Povidone-Iodine for Multidrug-Resistant Pseudomonas aeruginosa Exogenous Endophthalmitis: A Case Report and Literature Review

Introduction: The objective of this study was to report successful management of multidrug-resistant Pseudomonas aeruginosa endophthalmitis in a patient with a complex ophthalmic history using intracameral povidone-iodine (PI). Case Presentation: A 59-year-old male with a history of cataract surgery and multiple retinal detachment repairs presented with acute left eye pain, chemosis, redness, and vision loss. Diagnosis of exogenous endophthalmitis was made. The patient had anterior chamber washout, along with aqueous and vitreous tapping with intravitreal vancomycin, ceftazidime, and intravenous ciprofloxacin. Since infection persisted despite antibiotic therapies, a repeated anterior chamber washout followed by intracameral injection of PI 0.1% was done. Vision improved to 6/60 with no bacterial regrowth or inflammatory membranes on discharge and follow-up. Conclusions: Intracameral PI may offer a solution for endophthalmitis cases where standard antibiotics are ineffective. This case supports the potential role of PI in managing resistant intraocular infections.