Primary vitrectomy in endophthalmitis

Abstract

From January 1994 to January 1996, 18 patients underwent vitrectomy as a result of endophthalmitis. All patients received intraocular and systemic antibiotics in accordance with the first group of patients in the Endophthalmitis Vitrectomy Study. The aim of this retrospective study was to analyze the visual outcome of surgical treatment. Data from 18 consecutive patients, 11 women and 7 men, with the diagnosis of endophthalmitis as indication for vitrectomy were evaluated. The patients' ages ranged from 14 to 93 years (mean 66.6 +/- 21.3). Postoperative follow-up ranged from 6 weeks to 10 months. Endophthalmitis resulted from cataract surgery with implantation of an intraocular lens in 14 patients and from ocular trauma in 2 patients. Endophthalmitis followed the resection of posterior capsule fibrosis in 1 patient. Another patient suffered from endogenous endophthalmitis. Positive cultures were obtained in 12 patients. The most frequent causative organisms were coagulase-negative Staphylococcus (n = 7) and Streptococcus species (n = 4). Visual outcome: 13 of 18 patients (72%) gained a visual acuity of 20/400 or better at the final examination after vitrectomy. Four patients (22%) reached a visual acuity of 20/50 or better. Two eyes were enucleated. Good functional outcome was achieved in 2 patients with streptococcal infection (20/200; 30/50). Vitrectomy in combination with intraocular antibiotics is a suitable method for the treatment of endophthalmitis and results in preservation of ambulatory vision in 72% of patients. Vitrectomy in endophthalmitis can result in good functional outcome even in the case of infections with streptococcal species.