Propionibacterium acnes is a well-recognized cause of chronic postoperative endophthalmitis after cataract surgery. The subtle clinical signs of this infection and its initial favorable response to topical steroids may lead to delayed diagnosis and treatment. Two patients with culture proven P. acnes endophthalmitis after cataract surgery that presented with prominent pigmented keratic precipitates (KPs) and low-grade iritis in the involved eye were managed. Both cases had initial treatment with diagnostic pars plana vitrectomy (PPV) with intraocular antibiotic (IOAB) injection. Secondary treatment for recurrence was required in both patients. The KPs and iritis resolved after removal of intraocular lens (IOL) and capsular bag.
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