The analysis of the etiological factors and the treatment methods of exogenous endophthalmitis

Abstract

Objective To investigate the etiological factors and treatment methods of exogenous endophthalmitis. Methods Data of all cases of infectious endophthalmitis treated between August 2006 and December 2013 were reviewed retrospectively and compared with our earlier published report.One hundred and sixteen eyes of 116 cases aged from 18 to 90 years with mean (48.16±15.56) years were enrolled, including 77 male and 39 female patients.95.69% cases accepted vitrectomy and intravitreal antibiotics injection. The follow-up period was from 1 to 12 months. Results Endophthalmitis was in 83 eyes(71.55%) caused by penetrating injury, in 24 eyes (20.69%) caused by cataract surgery, in 5 eyes (4.31%) caused by anti-glaucoma surgery, in 2 eyes (1.72%) caused by vitrectomy and in 2 eyes(1.72%)caused by corneal ulcer perforation. Compared with our earlier report. the percentage of Gram-positive cocci isolates increased which occurred in 48 eyes accounting for 87.27%, while the percentage of the Gram-positive bacilli isolates was 5.45% which occurred in 3eyes and the percentage of Gram-negative bacilli isolates was 7.27% which occurred in 4eyes, both of which decreased. After vitrectomy and intravitreal antibiotics injection, postoperative visual acuity were ≥0.02 in 91 eyes(78.45%)and ≥0.3 in 38 eyes(32.76%). Conclusion Penetrating ocular injury and cataract surgery are the most common causes of infective endophthalmitis. Staphylococcus epidermidis was the predominant pathogen. Combined vitrectomy and intravitreal antibiotics injection was an effective treatment for endophthalmitis. Key words: Etiologic factors; Endophthalmitis, exogenous; Ocular trauma, penetrating; Surgery, cataract extraction; Vitrectomy