[Treatment of chronic pseudophakic endophthalmitis after cataract surgery]

To review our experience on the treatment of chronic pseudophakic endophthalmitis.

A retrospective and descriptive review of 6 consecutive cases: 4 after extracapsular cataract extraction and one after phacoemulsification with implant of posterior chamber intraocular lenses, and one aphakic patient after extracapsular cataract extraction. Treatment options included one or more of these techniques: intravitreal injection or anterior chamber injection or irrigation of the capsular bag with vancomycin (1.0 mg in 0.1 cc); pars plana vitrectomy with total or partial capsulectomy (with removal of the plaque) and the removal of the capsular bag and the intraocular lens through a limbal incision.

2 cases were managed with initial intravitreal vancomycin, associated in a third patient to a capsular bag irrigation. The two formers eventually required vitrectomy with posterior capsulotomy and removing of the white plaque; in a fourth patient, this technique was our initial step. Intraocular lens removal with capsular bag extraction was chosen as our first treatment measure on 2 patients and after vitrectomy failure in another case. Inflammation control was achieved in all our patients, although it took some time and some patients needed corticosteroids treatment during the meantime.

Treatment indications of chronic postoperative endophthalmitis are not clearly established. In our experience, the best results are achieved with the techniques that remove completely the white plaque or the capsular bag and the intraocular lens.