Clinical analysis of cataract surgery complicated by endophthalmitis

To assess the efficacy of vitrectomy combined with intravitreal injection in the treatment of endophthalmitis after phacoemulsification and IOL implantation.

Five patients (5 eyes), who had undergone conventional phacoemulsification combined with IOL implantation at another treatment facility, presented with endophthalmitis. The subjects ranged in age from 41 to 79 years (65.8 ± 0.5 years on average), and three were male. All five cases received bacterial culture susceptibility testing. On the basis of the treatment of primary disease, 3 cases had anterior chamber irrigation, and posterior vitrectomy followed by intravitreal injection of 1 mg vancomycin plus 2.25 mg ceftazidime.

Four out of the five cases of endophthalmitis had a positive bacterial culture testing results (two cases of staphylococcus epidermidis, one case of enterococcus faecalis and one case of head-like staphylococcus), and the remaining case had no bacterial growth. Four cases showed restored visual acuity, clear vitreous cavity, and no retinal detachment or other complications.

Management of patients presenting with endophthalmitis subsequent to cataract surgery should include: prompt bacterial culture and drug sensitivity tests, and where appropriate, vitrectomy combined with intravitreal injection of vancomycin.