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Visual Outcomes of Early Intravitreal Antibiotics and Factors Affecting Presumed Acute Endophthalmitis Post Cataract

Lily Rajbanshi1, Ananya Singh1, Kabma Shreflha1

  • 1Department of Vitreo-Retina, Biratnagar Eye Hospital, Biratnagar, Morang, Nepal.

JNMA; Journal of the Nepal Medical Association
|March 5, 2026
PubMed
Summary

Early intravitreal antibiotics significantly improved visual acuity in patients with post-cataract surgery infectious endophthalmitis. This treatment approach is crucial for managing this severe complication and preserving vision.

Keywords:
acute endophthalmitiscataract surgeryintravitreal antibioticsvisual outcomes

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Surgical Complications

Background:

  • Acute infectious endophthalmitis is a rare but severe complication following cataract surgery, potentially leading to vision loss.
  • Prompt diagnosis and treatment are critical to prevent irreversible photoreceptor damage.
  • Evolving clinical practices necessitate updated treatment guidelines beyond the Early Vitrectomy Study (EVS).

Purpose of the Study:

  • To evaluate the effectiveness of early intravitreal antibiotic treatment in patients with acute post-cataract surgery infectious endophthalmitis.
  • To analyze visual acuity outcomes at 60 days post-treatment.
  • To identify factors influencing visual outcomes in this patient cohort.

Main Methods:

  • An observational, retrospective single-center study analyzed data from patients diagnosed with endophthalmitis within six weeks of cataract surgery.
  • Patients received intravitreal antibiotics (vancomycin and ceftazidime) and underwent microbiological analysis.
  • Visual acuity (LogMAR) was assessed at baseline and 60 days; data were analyzed using SPSS version 29.0.

Main Results:

  • The majority of patients (87.70%) were aged 40-80 years; 57.14% were male.
  • Symptoms typically appeared within two weeks post-surgery (62%).
  • Intravitreal antibiotics alone were administered to 88% of patients, resulting in a significant visual acuity improvement (LogMAR from 1.395 to 0.441 at 60 days).

Conclusions:

  • Early therapeutic intervention with intravitreal antibiotics can improve visual outcomes in acute postoperative endophthalmitis.
  • Treatment effectiveness was observed at 60 days post-intervention.
  • No significant variations in visual acuity were linked to age, gender, or surgical technique.