Visual and Anatomic Outcomes in Delayed-Onset Endophthalmitis After Glaucoma Surgery: A 10-Year Case Series

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Infectious Disease

Background:

• Delayed-onset endophthalmitis is a rare but severe complication following glaucoma surgery.
• Early diagnosis and intervention are crucial for preserving vision and ocular integrity.

Purpose of the Study:

• To assess the clinical features, microbiology, and outcomes of delayed endophthalmitis after glaucoma surgery.
• To evaluate the effectiveness of early pars plana vitrectomy (PPV) in managing these cases.

Main Methods:

• Retrospective case series of patients with endophthalmitis ≥6 weeks post-glaucoma surgery (2013-2023).
• All patients underwent PPV within 24 hours; adjunctive procedures included bleb excision or device explantation.
• Primary outcomes: best-corrected visual acuity (BCVA) and anatomical success at 6 months.

Main Results:

• Fifteen eyes included; median infection interval 5.2 years post-surgery.
• Presenting BCVA was poor (93.3% hand-motion); cultures positive in 53.3%.
• At 6 months, median BCVA improved significantly (p<0.01), with 66.7% achieving ≥1.0 logMAR improvement; no enucleations required.

Conclusions:

• Early PPV combined with source control yields significant visual improvement.
• This management strategy achieves high rates of anatomical success in delayed endophthalmitis post-glaucoma surgery.