Abstract
Purpose: To determine the visual outcome of pars plana vitrectomy following endophthalmitis.
 Methods: A retrospective hospital-based study of 20 eyes of consecutive patients who had pars plana vitrectomy by a particular surgeon following endophthalmitis in the Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh from August – December 2017. Using the Snellen's visual acuity chart, post-operative distant visual acuity improvement was graded 0– 9, with 0 meaning no improvement in visual acuity, and 9 meaning nine lines of improvement in visual acuity from presenting best corrected visual acuity.
 Results: Pre-operative corrected distant visual acuity (CDVA) ranged from perception of light to 6/36. Seventy percent of the patients had postoperative visual improvement of varying degrees. The mean pre-operative and post-operative CDVA were 2.20 logMAR and 1.40 logMAR respectively. All the patients tractional retinal detachment and corneal laceration with rhegmatogeneous retinal detachment as co-morbidities did not have visual improvement, and this was statistically significant (p-value = 0.007). There was an association (although not strong) between age range and postoperative visual improvement (p-value = 0.639).
 Conclusion: Pars plana vitrectomy helps to prevent or minimize ophthalmic complications from endophthalmitis, thus making it a necessary line of treatment endophthalmitis. Pars plana vitrectomy is therefore a safe and desirable definitive treatment for endophthalmitis, and it confers a good chance of visual improvement.
Highlights
Pars plana vitrectomy has seen remarkable progress in surgical technique and postoperative outcome in ophthalmic practices all over the world
Pre-operative corrected distant visual acuity (CDVA) ranged from perception of light to 6/36, with hand movements being the most common pre-operative CDVA (8; 40%), followed by counting fingers (7; 35%) – Table 2
A majority (70%) of the patients in this study experienced different degrees of post-operative visual improvements, while 30% did not experience any improvement in their vision after surgery (Table 2)
Summary
Pars plana vitrectomy (the intricate surgical removal of vitreous gel from the vitreous cavity) has seen remarkable progress in surgical technique and postoperative outcome in ophthalmic practices all over the world. It has become the main stay of treatment for many surgical vitreous and retinal conditions, e.g. retinal detachments, retinal haemorrhage, retinal vaso-proliferative conditions, macular hole, intraocular foreign body, etc. With judicious use of broad-spectrum and new generation antibiotics, post-operative endophthalmitis has reduced in incidence. It still remains a major concern for every ophthalmic surgeon, as it confers an appalling visual prognosis.
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