Presumed Capsular-Bag-Origin Endophthalmitis following Anterior Vitrectomy for Posterior Capsule Opacification in a Patient with Proliferative Diabetic Retinopathy: A Case Report

Introduction: Chronic postoperative endophthalmitis is a rare but serious complication following intraocular surgery. We report a unique case of presumed capsular-bag-origin endophthalmitis that developed after anterior vitrectomy for posterior capsule opacification in a patient with proliferative diabetic retinopathy. Case Presentation: A patient with proliferative diabetic retinopathy underwent uncomplicated cataract surgery, followed by anterior vitrectomy for posterior capsule opacification. One month later, the patient experienced a marked decrease in visual acuity accompanied by dense vitreous opacity, despite minimal anterior chamber inflammation. Vitrectomy revealed inflammatory changes predominantly localized to the capsular bag. Based on the delayed onset, clinical course, and intraoperative findings, capsular-bag-origin endophthalmitis was suspected. Surgical intervention combined with appropriate antimicrobial therapy resulted in clinical improvement. Conclusion: Capsular-bag-origin endophthalmitis may present with limited anterior segment inflammation and delayed onset after anterior vitrectomy. This rare entity should be considered in patients with unexplained vitreous opacity following intraocular surgery, particularly in those with proliferative diabetic retinopathy.