[Primary vitrectomy with intravitreal antibiotic application in postoperative and posttraumatic endophthalmitis].
OBJECTIVE
The aim of our study was to evaluate the results of the treatment of postoperative and posttraumatic endophthalmitis by means of primary vitrectomy with intravitreal antibiotic application.


METHODS
In 42 patients treated for postoperative and posttraumatic endophthalmitis during the period January 2000-March 2006 at the University Department of Ophthalmology in Leipzig, Germany, EU, the postoperative visual acuity was followed-up. Furthermore, the results of microbial cultivation of the vitreous sample and the correlation between the final visual acuity and the causing etiological agent were evaluated. The treatment of endophthalmitis in 39 patients consisted of the primary vitrectomy with intravitreal antibiotics application; in three patients, solely the intravitreal injection of antibiotics was performed. In all patients, the antibiotics were administered locally and intravenously as well. The postoperative follow-up period lasted between 2 weeks to 24 months (median, 4.5 months).


RESULTS
The cause of endophthalmitis was in 31 (73%) patients the cataract surgery or secondary implantation of the intraocular lens; and in 4 (10%) patients the previous pars plana vitrectomy was performed. In 2 patients (5%) the endophthalmitis developed after trabeculectomy and in 5 (21%) patients, the endophthalmitis followed after perforating eye trauma. By means of microbiological cultivation, the agent was proved in 20 patients. The most common cause of endophthalmitis was Staphylococcus epidermidis. The postoperative improvement of the visual acuity we noticed in 39 patients. The final visual acuity better than 1/50 was reached by 88% of patients, thereof in 52% we proved at the end of the follow-up period the visual acuity better than 0.5.


CONCLUSIONS
The primary vitrectomy with intravitreal application of antibiotics combining with local as well as intravenous applications of antibiotics is a successful method of endophthalmitis treatment; in our study, in 88% of patients, the partial (orientational) vision was maintained.
Rehák
M
M
Ocní klinika, Univerzita Lipsko, Nemecko. matus.rehak@centrum.cz
Wiedemann
P
P
Meier
P
P
D000293:Adolescent; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D009877:Endophthalmitis / Q000209:etiology / Q000628:therapy*; D015807:Eye Injuries, Penetrating / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D014821:Vitrectomy
D000900:Anti-Bacterial Agents