Silicone Oil Tamponade in the Management of Endogenous Endophthalmitis

This study aimed to evaluate pars plana vitrectomy (ppv) with silicone oil tamponade in the management of patients with endogenous endophthalmitis.

All patients treated with ppv and silicone oil for endogenous endophthalmitis at the University Eye Hospital Bonn between 2015 and 2022 were included. We documented all preoperative data, encompassing BCVA at diagnosis, clinical observations, and presenting symptoms. During each follow-up visit, we evaluated BCVA and monitored for any complications. Statistical analysis was performed using SPSS Statistics.

In total, 19 eyes of 19 patients were included in this study. The most common underlying diseases were urosepsis in 5 patients (26.3%), endocarditis and leukemia in 3 patients (15.8%) respectively. The most common bacterial pathogens in the vitreous samples were gram-positive cocci in 3 patients (15.8%) and staphylococcus aureus in 3 patients (15.8%). The most common fungal pathogen was candida albicans in two patients (10.8%). Visual acuity (VA) at diagnosis was 1.93 logMAR (0.4-3.0 logMAR) and increased to 1.39 logMAR (0.2-3.0 logMAR) after six months and 1.21 logMAR (0.2-3.0 logMAR) after one year. 2 patients (10.5%) died during the follow-up because of their underlying disease. 9 eyes (47.4%) developed postoperative complications. One eye with no light perception was enucleated due to pain caused by high intraocular pressure. 2 eyes (10.5%) developed a postoperative retinal detachment needing further surgery.

Most patients treated with ppv and silicone oil for endogenous endophthalmitis experienced an improvement in visual acuity; however, due to the severity of the condition, the visual prognosis remains guarded.