Abstract
Purpose To describe and compare the clinical features and visual outcomes of endophthalmitis following intravitreal injections (IVI), cataract surgery, and pars plana vitrectomy (PPV). Methods This is a single-centre, retrospective study. All included patients had acute postoperative endophthalmitis secondary to one of these three procedures. Visual acuity (VA), comorbidities, time to presentation, and treatment were assessed. The primary outcome was visual outcome. A poor outcome was considered if final VA was worse than or equal to counting fingers (CF) and a good outcome was classified as VA better than CF. Results Over 12 years, a total of 61 patients were included. Twenty-seven cases were post-cataract endophthalmitis; twenty-five were post-IVI and nine post-PPV. Endophthalmitis post-PPV had a worse visual outcome (88.9% of patients with VA worse than or equal to CF 95% CI 51.3 to 100.0%) than endophthalmitis following cataract surgery (25.9% of patients with VA worse than or equal to CF 95% CI 11.0 to 39.9%) and the IVI subgroup (44.0% of VA worse than or equal to CF 95% CI 24.0 to 67.0%) (p=0.001 and p=0.047). There were no significant differences in the proportion of patients with a poor visual outcome between endophthalmitis following cataract surgery and IVI (p=0.171). Conclusions The number of patients with poor visual outcomes following acute endophthalmitis was similar in endophthalmitis following IVI and cataract surgery, but better than endophthalmitis following vitrectomy.
Highlights
Endophthalmitis is an infectious inflammation of the intraocular cavity
Over 12 years, from a total of 72 patients selected in our study, we excluded 11 patients due to missing data regarding final visual acuity. erefore, in our study, we included 61 cases, with 27 cases being post-cataract patients, 25 post-intravitreal injections (IVI), and 9 post-pars plana vitrectomy (PPV) patients
From the forty-eight patients who underwent therapeutic vitrectomy, 17 were post-cataract patients while 23 were post-IVI patients (p 0.013)
Summary
Endophthalmitis is an infectious inflammation of the intraocular cavity. it is an uncommon disease, it is sight-threatening and may lead to irreversible vision loss [1]. Secondary outcomes collected included clinical features such as age, gender, comorbidities, therapeutic vitrectomy, time in days from surgical procedure to the onset of symptoms, presenting VA, time until the treatment of endophthalmitis with vitrectomy, final VA, and type of tamponade in PPV surgery. Ere were no significant differences in the proportion of patients with a poor visual outcome between endophthalmitis following cataract surgery and IVI (p 0.171).
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