Epidemic endophthalmitis after cataract surgery

We analyzed the results of pars plana vitrectomy in group of patients with a view to establishing risk factors, optimal therapy, surgical technique and the best timing of the pars plana vitrectomy.

Eight patients presented features of bacterial endophthalmitis within two days of cataract extraction. We examined the relations between visual outcome and the identity of infecting species, optimal therapy, surgical technique and vitrectomy timing.

Pseudomonas aeruginosa was a pathogenic microbe. Unfortunately the source of infection was not found. The long-term (9-12 months) results are not good. Final visual acuity of all eight patients oscillated between 20/200 and no light perception. Three patients were first treated with intravitreal ATB application and vitrectomy followed with 36 hours lateney. Their final VA was no light perception in two patients and hand motion in one. The outcome was better in five patients operated immediately after the onset of endophthalmitis. Final visual acuity in this group was between hand motion and 20/200.

Visual prognosis in cases of endophthalmitis is closely related to the type of infecting organism, the visual acuity at presentation, and the speed of progression of inflammatory signs. The need for prompt vitrectomy as the only chance of retaining at least basic visual functions is fully demonstrated.