Abstract
Developing due to infectious and noninfectious causes, endophthalmitis is a serious condition requiring urgent intervention which can lead to eye loss. In recent years, medical and surgical approaches had great improvement in the treatment of endophthalmitis. Early diagnosis and therapy are very important in endophthalmitis. By prompt and accurate treatment, good outcomes are established. In order to get successful results, the combination of intravitreal antibiotic and pars plana vitrectomy approach is the best treatment modality. Early pars plana vitrectomy eliminates infective agents, suitable media, and toxins while amplifying the action of intravitreal antibiotics.
Highlights
Endophthalmitis is a severe, purulent intraocular inflammation of the intraocular cavities usually caused by infection
Acute postoperative endophthalmitis and secondary intraocular lens (IOL) implantation patients who were having an initial visual acuity between 20/50 and light perception, and had a view sufficient to perform a vitrectomy were included in the study. 420 patients were randomized to immediate initial TAP or vitrectomy
There was no difference in final visual outcomes in patients who underwent initial TAP or vitrectomy if presenting visual acuity was better than light perception
Summary
Endophthalmitis is a severe, purulent intraocular inflammation of the intraocular cavities (i.e. the aqueous or vitreous humor) usually caused by infection. 70 percent of cases occur as a direct complication of intraocular surgery Such post-operative endophthalmitis may be acute (presenting within 6 weeks of surgery) or chronic. Blood-borne organisms permeate the blood-ocular barrier either by direct invasion (e.g. septic emboli) or by changes in vascular endothelium caused by substrates released during infection. Destruction of intraocular tissues may be due to direct invasion by the organism and/or from inflammatory mediators of the immune response. It is seen in patients in whom body immunity is compromised e.g. chronic alcoholics, HIV patients, malignancy, renal transplant patients. The management of endophthalmitis revolves around intense medical treatment and surgical intervention, with salvaging the eye and vision as primary aim (Table 1). Easier to operate on a non inflamed eye and to start specific treatment
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