POSTINTRAVITREAL INJECTION AND POSTCATARACT EXTRACTION ENDOPHTHALMITIS VISUAL OUTCOMES BY ORGANISM: A SYSTEMATIC...

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Endophthalmitis, a serious intraocular infection, can occur after intravitreal injections (IVIs) and cataract extraction.
• Understanding the impact of causative organisms on visual outcomes is crucial for patient management and prognosis.

Purpose of the Study:

• To compare visual outcomes of endophthalmitis following intravitreal injections (IVIs) and cataract extraction, stratified by causative organism.
• To update and validate previous findings on microbial etiology and visual prognosis in endophthalmitis.

Main Methods:

• A systematic review and random-effects meta-analysis of studies published between January 2010 and February 2022.
• Searches conducted across Cochrane Central Register of Controlled Trials, MEDLINE, and Embase databases.
• Included 85 studies reporting visual outcomes by causative organisms in post-IVI and post-cataract extraction endophthalmitis.

Main Results:

• Coagulase-negative staphylococci and gram-negative organisms were associated with the best visual acuity improvement in both post-IVI and post-cataract extraction endophthalmitis.
• Other gram-positive organisms, including streptococci and enterococci, showed less visual improvement.
• Culture-negative endophthalmitis cases demonstrated better visual acuity improvement than culture-positive cases after IVIs.

Conclusions:

• The visual outcomes of endophthalmitis are significantly influenced by the causative microorganism.
• Findings are consistent with the Endophthalmitis Vitrectomy Study, indicating persistent trends despite advancements in eye care.
• Coagulase-negative staphylococci and gram-negative bacteria represent favorable prognostic indicators for visual recovery in endophthalmitis.