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Management of endophthalmitis changed since 1995, but visual outcome still poor
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The management of endophthalmitis after cataract surgery has changed since the Endophthalmitis Vitrectomy Study was published in 1995, but visual acuity outcomes have not improved, according to a retrospective study. The study suggests that treatment with oral antibiotics may be associated with better visual outcomes.
Jonathon Q. Ng, MBBS, and colleagues at the University of Western Australia reviewed the records of all cases of clinically diagnosed endophthalmitis after cataract or lens-related surgery in Western Australia from 1980 to 2000. They identified 213 episodes of endophthalmitis in the region during the period.
“Although we observed noticeable changes in the diagnosis and management of endophthalmitis since 1995, visual outcomes have not improved and remain poor,” the study authors said.
The researchers found a significant increase in anterior chamber sampling and vitreous sampling since 1995, and an increase in the overall use of vitrectomy, from 59.5% in 1995 to 72.5%. Use of intravitreal antibiotics increased significantly, and the use of subconjunctival and intravenous antibiotic decreased.
Visual acuity 6 months after admission for endophthalmitis was worse than 6/18 in one-third of patients, and a worse visual outcome was more likely without oral antibiotics then with them, the researchers found.
“Our finding that treatment with oral antibiotics may be associated with a better visual outcome warrants further investigation,” the study authors said.
The study is published in the July issue of Ophthalmology.