Gentamicin-induced macular infarction in transconjunctival sutureless 25-gauge vitrectomy.

PURPOSE: State Gentamicin antibiotic prophylaxis is contraindicated in 25 gauge Transconjunctival Sutureless Vitrectomy. METHODS: A 75-year-old diabetic woman was affected by glaucoma and mild diabetic retinopathy in both eyes, and epiretinal membrane in the left eye. A 25-gauge Transconjunctival Sutureless Vitrectomy (TSV) was performed with self-sealing transconjunctival scletomies of the left eye. Post-operation antibiotic prophylaxis was obtained by subconconjunctival injection of Gentamicin sulfate (0.4 mg/ml) adjacent to scletomies. RESULTS: A month after the operation visual acuity had not recovered. Fluorescein angiography detected occlusion of perifoveal capillaries. CONCLUSION: Antibiotics, in particular gentamicin, have the potential to cause significant ocular toxicity when they gain access to the inside of the eye, through thinned sclera or sutureless sclerotomies of TSV.