Effect of Internal Limiting Membrane Peeling in Visual Outcome of Endophthalmitis after Pars Plana Vitrectomy

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Purpose: To evaluate the clinical course and prognostic factors of visual acuity in post-vitrectomy endophthalmitis. Methods: A total of 9 patients diagnosed with post-vitrectomy endophthalmitis between 2004 and 2013 were enrolled in this retrospective study. To evaluate factors affecting final visual acuity, the following was investigated: best corrected visual acuity (BCVA) before first vitrectomy, BCVA at presentation, presence of diabetes mellitus, type of port used on first pars plana vitrectomy, whether cataract operation was performed simultaneously, whether removal of internal limiting membrane was performed at first pars plana vitrectomy, interval period from initial vitrectomy to treatment of endophthalmitis, presence of hypopyon, whether culture was proven, and type of organism isolated. Results: All 9 eyes received intravitreal antibiotic injections and additional pars plana vitrectomy was performed in 7 eyes. Six eyes were culture-proven. Staphylococcus epidermidis was cultured from 5 eyes and Escherichia coli was cultured from 1 eye. BCVA before first vitrectomy, presence of diabetes mellitus, type of port used on first pars plana vitrectomy, whether cataract operation was performed simultaneously, interval from initial vitrectomy to treatment of endophthalmitis, whether culture proven, and type of organism isolated did not affect final visual acuity. BCVA at presentation was an important factor for final visual acuity. Removal of internal limiting membrane at initial vitrectomy was a poor prognostic factor in final visual acuity (p = 0.02). Conclusions: Endophthalmitis after pars plana vitrectomy showed very poor final visual acuity and better BCVA at presentation resulted in better final visual acuity. Poor visual acuity was observed in patients who had the internal limiting membrane removed at first vitrectomy. J Korean Ophthalmol Soc 2015;56(2):213-218