Better outcomes may be observed with delayed-onset endophthalmitis after cataract surgery

Am J Ophthalmol. 2011;doi:10.1016/j.ajo.2011.08.029.

Superior initial visual acuities, fewer cases of hypopyon and better visual outcomes may occur in patients with delayed-onset endophthalmitis as opposed to those with acute-onset endophthalmitis, a study found.

The retrospective, consecutive case series included 118 patients treated between 2000 and 2009. Twenty-six were delayed-onset cases, occurring more than 6 weeks after cataract surgery, and 92 were acute-onset cases, occurring at 6 weeks or less after surgery.

Presenting visual acuity was 5/200 or less in 31% of delayed-onset cases vs. 89% of acute-onset cases; hypopyon presented in 46% vs. 80%, respectively. Propionibacterium acnes was the most popular isolate in the delayed-onset group, occurring in 11 of 26 patients, while coagulase-negative Staphylococcus was the most popular for acute-onset cases, presenting in 57 of 92 patients.

The two isolates were associated with the best visual acuity outcomes in each group; patients achieved 20/100 or better vision in 91% of delayed cases and 56% of acute cases.

The study was limited by variability between multiple physicians, as well as its retrospective nature and small sample size.