[Endophthalmitis after intraocular interventions]

Endophthalmitis is serious complication of intraocular surgery. At the University Eye Clinic Bratislava we performed a retrospective study on the occurrence of endophthalmitis after various intraocular procedures.

Over the years 1993-1995 we performed 2374 cataract extractions, 305 anti-glaucoma operations, 106 perforating keratoplasties and 926 pars plana vitrectomies. The charts of all patients were reviewed. The occurrence of endophthalmitis, type of surgery, perioperative complications, elapsed time between surgery and start of endophthalmitis, results of preoperative conjunctival smear cultures, final anatomical and functional results were evaluated.

The frequency of endophthalmitis after cataract extraction was 0.84%, after antiglaucoma surgery 1.31% and 0.97% after pars plana vitrectomy. No endophthalmitis was found after penetrating keratoplasties. In most cases endophthalmitis began in the first three days after surgery. Endophthalmitis occurred after uncomplicated as well as after surgical procedures with various perioperative complications. The preoperative conjunctival smear cultures were sterile in 22 patients. Staphylococcus epidermidis was the most commonly cultured germ. All patients were treated with antibiotics parenterally and locally. Pars plana vitrectomy and intravitreal application of antibiotics was performed only exceptionally. Enucleation was required in two eyes and two other eyes become phthitical. 22 eyes recovered without serious complications. Five eyes were blind and in 11 eyes the final visual acuity was better than 6/36.

Pre-, peri-, and postoperative measures must be improved to prevent postoperative endophthalmitis. In cases of endophthalmitis all therapeutical options have to be performed as soon as possible to save the patient's eye and sight.