Abstract
Endophthalmitis is a potentially devastating ocular complication of perforating eye injury (PEI) where prompt intervention can save some vision. This study aims to explore the clinico-microbiologic profile and visual outcome following pars plana vitrectomy (PPV) in traumatic endophthalmitis. This is a retrospective interventional case series study conducted at a tertiary eye care centre of Nepal. A total of 49 consecutive cases (49 eyes) of endophthalmitis following PEI, who underwent PPV from January 2007 to June 2010 were included in the study. Mean age was 14.7 years (S.D. 14.27). Twenty seven patients (55%) were of age group below 10 years. Male to female ratio was 2.75:1. Mean duration of presentation was 8.9 days. Nineteen eyes (36.73%) had injuries with wooden sticks, followed by injury with metallic objects in 16 patients (32.56%). PEI involving zone I was found in 31 eyes (63.25%). The retained intraocular foreign body was found in seven patients (14.2%). The post operative vision improved in almost 24 cases (49%) with visual recovery of 20/200 and better in six cases (12.24%). The vitreous culture was positive in five cases (12.8%) with predominant streptococcus pneumonia in four cases (10.25%). Children were the mostly affected group with males outnumbering females. Wooden sticks and metallic objects were the commonest insulting agents. Despite the late presentation and predominant zone I injury, eye could be salvaged in majority with visual recovery of 20/200 and better in six cases (12.24%).
Highlights
Endophthalmitis is a potentially devastating ocular complication of perforating eye injury (PEI) where prompt intervention can save some vision
There were total of 49 eyes of 49 cases with post traumatic endophthalmitis who were treated with pars plana vitrectomy (PPV) along with adjunctive intravitreal, topical and systemic medications during the study period
The post operative visual acuity improved in 24 cases (49%) following vitrectomy with good visual recovery of 20/20 and better in three patients (6.12%) and 20/200 and better in six patients (12.24%)
Summary
Endophthalmitis is a potentially devastating ocular complication of perforating eye injury (PEI) where prompt intervention can save some vision. This study aims to explore the clinico-microbiologic profile and visual outcome following pars plana vitrectomy (PPV) in traumatic endophthalmitis. Endophthalmitis is a potentially devastating ocular complication of perforating eye injury where delay in treatment results in sight loss and makes it difficult to save the eye ball. Incidence of post-traumatic endophthalmitis ranges from two to 17%.1-2. Lack of awareness about the safety measures and delay in treatment further complicate the situation in developing countries. With limited studies on the post-traumatic e_n_d_o_p_h_th_a_lm_i_ti_s_i_n_d_e_v_e_lo_p_in_g__na_t_io_n_s_l_ik_e__N_ep_a_l,__w_e Correspondence: Dr Raba Thapa, Vitreo-retinal Service, Thapa et al Clinico-microbiological Profile and Visual Outcome in Traumatic Endophthalmitis following Pars Plana Vitrectomy
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