Endophthalmitis: what role does vitrectomy play?

Abstract

PurposeTo evaluate predictors of visual outcome in a series of patients treated for postoperative endophthalmitis (PE) and analyze the role of therapeutic vitrectomy (TV).MethodsAll patients who were clinically diagnosed with endophthalmitis and underwent eye procedure less than six weeks before presentation were included. Visual acuity (VA) was assessed and intravitreal antibiotics administered at the time of diagnosis for all patients. Some of them underwent TV. Main outcomes were best VA after treatment and variation of VA.ResultsSixty‐one patients were included. Group of patients who underwent TV have a statistically significant greater proportion of patients with comorbidities (42.4% vs 17.9%) and median of VA after treatment was worse (2.1 LogMAR vs 0.5 LogMAR). Good VA, defined as ≤ 0.3 LogMAR, were reached only by 13 of 49 patients (26.5%). Presenting VA and performance of TV presented statistically significant differences in this analysis. On simple linear regression, we found that age, worse VA at diagnosis and the performance of TV were significantly associated to worse VA after treatment, and that longer time to the onset of symptoms and until TV are significantly associated with sorter variation of VA. Performing TV in the first 24 h after diagnosis presents a greater variation of VA than performing it after this time. After first 24 h, there seems to be increasingly worse outcomes with longer periods.ConclusionsOur findings are consistent with previous ones. TV should be done considering the overall clinical course and each patient's characteristics, but if it was the option, shouldn't be delayed