Pseudophakic endophthalmitis. Diagnosis and management

Area of Science:

• Ophthalmology
• Infectious Diseases

Background:

• Endophthalmitis is a serious intraocular infection.
• Intraocular lenses (IOLs) are commonly used in cataract surgery.
• Understanding outcomes in IOL-associated endophthalmitis is crucial.

Purpose of the Study:

• To analyze outcomes of endophthalmitis in eyes with intraocular lenses.
• To identify factors influencing visual acuity and infection control.

Main Methods:

• Retrospective review of 83 cases of endophthalmitis with IOLs.
• Analysis of causative organisms, surgical interventions, and visual acuity outcomes.
• Correlation of outcomes with IOL retention and treatment strategies.

Main Results:

• 22% of cases had contributing cataract section issues.
• 75% of eyes were culture-positive, with Staphylococcus epidermidis being the most common pathogen (38%).
• Therapeutic vitrectomy was performed in 55% of cases; IOLs were removed in 28% to facilitate vitrectomy.

Conclusions:

• Retaining the intraocular lens in bacterial endophthalmitis cases led to successful sterilization in most instances (1 of 57 eyes could not be sterilized).
• Good visual acuity (≥20/400) was achieved in 63% of culture-positive cases, 78% of S. epidermidis cases, and 94% of culture-negative cases.
• IOL retention appears safe and effective in managing endophthalmitis, facilitating better visual outcomes.