[Study of panophthalmitis after cataract surgery from 1997 to 1999].
OBJECTIVE
To define the clinical outcome and microbiological pattern of bacterial endophthalmitis that were referred at the Jules Gonin Eye Hospital from January 1997 to September 1999.


METHODS
Patients were recorded in a computerised databank and were managed according to a standard protocol. An anterior chamber tap combined with a vitreous biopsy by the pars plana was performed in all patients. The treatment included an intravitreal injection of 1 mg Vancomycin and 400 micrograms Amikacin diluted in 0.2 ml NaCl 0.9%. Postoperatively hourly therapy Cefazolin 50 mg/ml and Garamycin 9 mg/ml was applied. To determine possible risks factors a standard form was sent to all referring surgeons. The following data were analysed: delay of onset, risk factors, initial and final visual acuity.


RESULTS
From January 1997 to September 1999, 31 patients were referred. 18/31 (58%) of the cases were admitted between April and June of each years. The mean age was of 75 +/- 10 years. Initial visual acuity ranged from light perception to 20/40. 17/31 of the patient's cultures were positive. The major pathogen were Staphylococcus epidermidis in 9/31 patients and Staphylococcus aureus in 4/31 patients. No correlation between the endophthalmitis and the surgical technique or perioperative management of the patient, could be determined. Visual outcome was significantly improved in 56.7% of the patients.


CONCLUSIONS
The severity of outcome could be correlated to the type of bacteria isolated. The high prevalence of panophthalmitis from March to June suggests that a climatic factors may be involved in its pathogenesis.
Titzé
P
P
Hôpital Jules Gonin, Service d'ophtalmologie, Lausanne, Suisse.
Othenin-Girard
P
P
Bernasconi
O
O
Bornet
C
C
Guex-Crosier
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D012621:Seasons; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000382:microbiology*; D013557:Switzerland / Q000453:epidemiology
Etude sur les panophtalmies après chirurgie de la cataracte de 1997 à 1999.