Related Experiment Videos
Endophthalmitis following extracapsular cataract surgery: a review of 32 cases
C J Heaven1, P J Mann, D L Boase
1Department of Ophthalmology, Queen Alexandra Hospital, Cosham, Portsmouth.
Abstract:
Thirty two cases of endophthalmitis following extracapsular cataract surgery that had occurred within our department and had undergone intraocular diagnostic tap between May 1982 and May 1991 were reviewed. An infectious agent was identified in 20 cases (62.5%). The commonest organism was Staphylococcus epidermidis (11 cases) (55%). Proteus was the only gram negative organism identified (four cases) (20%). Both of these organisms were associated with a favourable visual outcome. In the culture positive subgroup 15 eyes (75%) achieved a final acuity of 6/60 or better with 10 eyes (50%) gaining 6/12 or better. Thirteen (65%) of the culture positive cases were managed without vitreal intervention. Of these 11 (85%) achieved 6/60 or better with eight (62%) gaining 6/12 or better. It appears that when an endophthalmitis follows uncomplicated extracapsular cataract surgery delivery of antibiotic by the 'conventional' routes (topical, subconjunctival and systemic) is consistent with a favourable visual result in many cases. A modified anterior chamber diagnostic tap technique is described.
Insights
Infectious endophthalmitis after cataract surgery often involves Staphylococcus epidermidis or Proteus, both linked to good visual outcomes. Conventional antibiotic delivery can lead to favorable results, even without vitreal intervention.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Endophthalmitis is a serious complication following cataract surgery.
- Early identification and management of causative agents are crucial for visual prognosis.
Purpose of the Study:
- To review cases of endophthalmitis post-extracapsular cataract surgery.
- To identify common infectious agents and their impact on visual outcomes.
- To evaluate the effectiveness of conventional antibiotic delivery methods.
Main Methods:
- Retrospective review of 32 cases of endophthalmitis.
- Intraocular diagnostic taps performed between May 1982 and May 1991.
- Microbiological analysis to identify infectious agents.
Main Results:
- Infectious agents identified in 62.5% of cases.
- Staphylococcus epidermidis (55%) and Proteus (20%) were the most common organisms.
- Favorable visual outcomes (≥6/60) achieved in 75% of culture-positive cases.
- Successful management without vitreal intervention in 65% of culture-positive cases.
Conclusions:
- Staphylococcus epidermidis and Proteus infections following cataract surgery are associated with favorable visual outcomes.
- Conventional antibiotic routes (topical, subconjunctival, systemic) can yield good results.
- A modified anterior chamber diagnostic tap technique was developed.