April 14, 2014
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Endophthalmitis after vitrectomy associated with poor postop prognosis

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A substantial number of patients with infectious endophthalmitis after pars plana vitrectomy had poor clinical and visual outcomes, according to an epidemiologic study.

Investigators collaborated with the British Ophthalmic Surveillance Unit on an analysis of 37 reported cases of presumed postoperative endophthalmitis after pars plana vitrectomy; 28 cases met the diagnostic inclusion criteria.

The most common presenting signs and symptoms of endophthalmitis were blurred vision (85.2%), pain (77.8%), hypopyon (77.8%), increased eye redness (55.6%), absent red reflex and lid swelling (25.9%).

Seventeen cases (60.7%) had positive cultures based on vitreous cavity biopsy or anterior chamber tap. Cases of culture-positive endophthalmitis and culture-negative endophthalmitis had similar time to presentation, symptoms and outcomes.

Twenty-seven cases were able to provide a monocular visual acuity at the final follow-up. Eight eyes (29.6%) were eviscerated or had no light perception. Visual acuity was counting fingers in one eye (3.7%), 6/18 to 1/60 in 14 eyes (51.9%) and 6/12 or better in four eyes (14.8%).

No cases of postoperative retinal detachment or hypotony were reported.

Disclosure: Ling has received sponsorships from Allergan and Novartis for attending conferences.