title: [Prognosis of postoperative endophthalmitis].
abstract: BACKGROUND
  The outcome of 20 patients is summarized in a retrospective study to identify clinical findings that influence the long-term prognosis of postoperative endophthalmitis.
  
  
  METHODS
  Between 1991 and 1997 a total of 20 patients with postoperative endophthalmitis were admitted. Median age was 80 years (range: 9-95), 11 patients were male, 9 female. Sixteen pars-plana vitrectomies, 2 anterior vitrectomies and 2 rinsings of the anterior chamber without vitrectomy were performed. Furthermore, all patients received intraocular and systemic antibiotic treatment. For microbiological investigation, specimens from vitreous, anterior chamber and conjunctiva were sent in. Long-term outcome was controlled for an average of 14 months after treatment of the endophthalmitis (range: 4-36 months).
  
  
  RESULTS
  At the end of treatment, 40% of patients had a visual acuity of 0.4 or better, 80% had 1/20 or better. Patients with a preoperative visual acuity of at least hand movement had a better postoperative visual outcome than patients with only light perception. Visual acuity was better in patients with chronic endophthalmitis than in patients with acute or subacute endophthalmitis. In patients with chronic or subacute endophthalmitis, improvement of visual acuity was found some months after the operation more often than in patients with acute endophthalmitis. However, in 40% of cases with an acute onset, no improvement or even worsening of the visual acuity was documented. Best postoperative results were found after infection with Staphylococcus epidermidis and Propionibacterium acnes.
  
  
  CONCLUSIONS
  Important prognostic factors of postoperative endophthalmitis are visual acuity, the onset of the endophthalmitis (acute, subacute or chronic) and the microbiological findings. At the time of surgery and antibiotic treatment, visual acuity should be at least hand motion to expect an improvement in the visual outcome.
authors.affiliation: Universitäts-Augenklinik Jena.
authors.forename: E
authors.initials: E
authors.lastname: Königsdörffer
authors.forename: R
authors.initials: R
authors.lastname: Augsten
authors.forename: A
authors.initials: A
authors.lastname: Oehme
authors.forename: J
authors.initials: J
authors.lastname: Strobel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D002648:Child; D009877:Endophthalmitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005123:Eye / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000175:diagnosis*; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014792:Visual Acuity
chemical_list: D000900:Anti-Bacterial Agents