Endophthalmitis after cataract surgery

Abstract

Aims/Purpose: Retrospective review in 164 patients with endophthalmitis after cataract surgery, and intended to figure out the factors which affect clinical features, bacteria identification and final visual acuity (VA).Methods: We followed the guideline of EVS for operative treatment. In the case of initial LP, vitrectomy was conducted. HM or better, either IOAI (intraocular antibiotics injection, 1.0 mg/0.1 mL of vancomycin and 2.25 mg/0.1 mL of ceftazidime) or vitrectomy was optionally conducted. After initial treatment, we conducted reintervention within 48 h where the decrease of vitreous opacity and hypopyon, and pain relief did not show up. We obtained A/C fluid and vitreous specimen for figure out the bacteria identification.Results: 25 patients had initial VA below LP, the cases of HM were 86 and 53 patients had better than FC. 81 patients were observed where it took 3 days until the symptoms of post‐operative endophthalmitis occurred. Where final VA improved by 0.5 or better, the case that vitrectomy was conducted with early treatment was not statistically much different from the case of sole IOAI. The influential factors in final VA was where it took more than 3 days for endophthalmitis to occur after cataract surgery, initial VA was HM or better, and the result of bacteria identification was Gram(+) and those 3 cases affected the positive outcomes.Conclusions: Good initial VA means the diagnosis of endophthalmitis was relatively prompt. It can be said that intraocular tissues were less damaged, the virulent would be infected by less bacteria and then those affect positive prognosis. In addition, endophthalmitis diagnosed 3 days later after surgery, prognosis was good. It seems that this is because damage of intraocular tissues occurs slowly as pathogenicity did not progress quickly with light clinical features where it is infected by weak bacteria. And it can be considered that the period until post‐operative endophthalmitis occurs affects prognosis.