[Postoperative acute endophthalmitis: a prospective study. Clinical presentation, management and prognostic factors].
OBJECTIVE
To assess the characteristics and visual outcome of patients with acute postoperative endophthalmitis hospitalized in a referral center.


METHODS
All patients suspected of having infectious endophthalmitis were included in this study. All patients were treated with the same protocol including at least intravitreal injection of antibiotics and instillation of fortified antibiotics. Symptoms, visual acuity, and slit lamp examination were recorded before treatment, at the end of hospitalization and during clinical follow-up. Treatments and biological results were also reported. For patients developing infectious endophthalmitis after cataract surgery, intraoperative management such as location of the incision, suture or sutureless incision, and material of the intraocular lens were also noted.


RESULTS
Forty-one patients were included in the study over 32 months (33 patients after cataract surgery). Intraocular inflammation and a decrease in subjective visual acuity were the most frequently reported findings (90% and 94%, respectively). Ocular pain and conjunctiva injection were less frequently reported (47% and 48%, respectively). Symptoms occurred 5 days after the surgery (median); 56% of patients needed a second intravitreal injection of antibiotics. There was a significant increase in visual acuity during and after hospitalization; median final visual acuity was 4.6/10 (0.34 log MAR = 20/43); 30% of patients had less than 20/200, but 44% more than 20/40. In endophthalmitis following cataract surgery, incisions were corneal in all cases and sutured in 62% of cases. Incisions were temporal in 55% of patients.


CONCLUSIONS
Our results are similar to those previously published for acute endophthalmitis following ocular surgery. Intravitreal antibiotic injection remains the gold standard on the management of acute postoperative endophthalmitis.
Lafontaine
P-O
PO
Service d'Ophtalmologie, Centre Hospitalier Universitaire, Dijon, France. Pierre-olivier.lafontaine@chu-dijon.fr
Bron
A M
AM
Creuzot-Garcher
C
C
D000208:Acute Disease; D000368:Aged; D002985:Clinical Protocols; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D014792:Visual Acuity