Acute endophthalmitis after cataract surgery: 164 consecutive cases treated at a referral center in South Korea

Abstract

PurposeTo identify prognostic factors in patients referred with endophthalmitis after cataract surgery, and to evaluate the efficacy of primary vitrectomy as an initial management.MethodsOver an eight-year study period, we retrospectively reviewed the medical records of 164 patients who were referred with endophthalmitis following cataract surgery. Treatment generally conformed to standard guidelines, although primary vitrectomy was performed in several eyes with a visual acuity of hand motion or better, depending on the patient's status. Using multivariate analysis, we analyzed outcomes to determine the effect on final visual outcome.ResultsA final visual acuity of ≥20/40 was achieved in 92/164 (56.1%) cases after treatment. Bacterial cultures showed bacterial growth in 89/164 cases (54.3%). Among the various baseline characteristics, old age (P=0.028), poor visual acuity at presentation (P=0.004), gram-negative bacterial infection (P=0.030), and short time between cataract surgery and signs of endophthalmitis (P=0.021) were associated with poor visual outcome. The visual outcome showed no significant difference, in terms of initial treatment feature, between the primary vitrectomy with intraocular antibiotics injection (IOAI) and IOAI-only groups. However, reintervention was significantly less frequent in the primary vitrectomy group than in the IOAI group (12.5 and 32.7%, respectively; P=0.002).ConclusionOld age, poor visual acuity at presentation, type of cultured organism (gram-negative bacteria), and early onset of endophthalmitis after cataract surgery were significantly related to poor visual outcome after endophthalmitis treatment. Primary vitrectomy may decrease the need for reintervention to control infection, although the treatment showed no benefits with regard to visual outcome.

Acute postcataract endophthalmitis at a referral center in northern Taiwan

“…Previous studies have reported that sex was not significantly related to final VA. [ 13 , 14 ] Other studies have demonstrated that sex was significantly associated with final visual outcome. [ 9 , 11 ] Consistent with second group of studies, [ 9 , 11 ] our study showed a significant association between sex and final visual outcome.…”

“…[ 7 ] However, several recent studies have reported the efficacy and advantages of early primary vitrectomy for postcataract endophthalmitis, and early primary vitrectomy has become one option for patients with VA better than LP. [ 9 , 10 ]…”

“…Given that the visual prognosis varies widely and depends largely on the etiologic organism, [ 7 , 9 , 11 ] prompt diagnosis of the condition and early initiation of treatment are crucial to obtaining the best possible outcome. The purpose of this study was to analyze the current causative agents, clinical features, and visual outcomes associated with acute-onset postcataract endophthalmitis between 2009 and 2015 at a referral center.…”

Seleção de marcadores para a busca ativa de endoftalmite após cirurgia de catarata

“…Após a facectomia, os pacientes do GC necessitaram de poucas revisões cirúrgicas, que não estavam relacionadas a complicações infecciosas. Em contraste, os pacientes com endoftalmite foram submetidos a pelo menos uma e até três revisões cirúrgicas, como consequência direta da evolução do caso, o que está de acordo com estudos que descrevem o tratamento da endoftalmite 3,6,7,19 . O número de retornos para o acompanhamento pós-operatório de pacientes com endoftalmite (GE) foi significativamente maior do que o GC.…”

Pars Plana Vitrectomy in Post-Cataract Surgery Endophthalmitis in Cipto Mangunkusomo Hospital

“…Other study reported the age of patients at diagnosis ranged between 56-84 years old. 12 Age over 50 years old is a factor associated with poor outcomes in final VA. 13 Cases with presenting visual acuity better than light perception (LP) is a significant factor for achieving better final visual acuity. 10 In this study, it was found that cases with initial VA better than 1/300 could get improvement in final VA by 50%, while cases with initial VA worse than 1/300 only 2 out of 5 cases (40%) had better final vision.…”