Acute-onset endophthalmitis after cataract surgery: success of initial therapy, visual outcomes, and related factors.
OBJECTIVE
To evaluate the success of initial treatment and the factors influencing the outcome in acute-onset endophthalmitis after cataract surgery.


METHODS
We retrospectively reviewed the medical records of all patients with acute postoperative endophthalmitis between 2000 and 2007. We performed pars plana vitrectomy (PPV) to all eyes with initial visual acuity of light perception. Eyes with visual acuity of hand motions or better underwent either intraocular antibiotic injection (IOAI) or PPV. Eyes that did not give a good clinical response to initial therapy within 60 hours underwent a second procedure. The main outcome measure was the rate of early reintervention after PPV and IOAI.


RESULTS
We evaluated 88 eyes of 88 patients. Thirty-seven patients underwent PPV and 51 patients underwent IOAI alone. Six of 37 (16.2%) patients required 1 or more procedures within 60 hours of the initial procedure in the PPV group. Twenty-eight of 51 eyes (54.9%) in the IOAI group underwent PPV within 60 hours. The rate of response to primary PPV was significantly higher than to primary IOAI (P < 0.001). Gram-negative organisms composed 35.1% of the isolates.


CONCLUSIONS
Pars plana vitrectomy may be preferable to IOAI in postoperative endophthalmitis since the rate of early reintervention is lower with initial PPV.
Altan
Tugrul
T
2nd Eye Clinic, Beyoglu Eye Training and Research Hospital, Istanbul. tugrulaltan@gmail.com
Acar
Nur
N
Kapran
Ziya
Z
Unver
Yaprak Banu
YB
Yurttaser
Serap
S
Küçüksümer
Yaşar
Y
Eser
Ilker
I
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D011183:Postoperative Complications; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy
D000900:Anti-Bacterial Agents