Risk factors for endophthalmitis requiring evisceration or enucleation

Abstract

Endophthalmitis has devastating sequelae resulting in blindness and even loss of eyeball. Although the prognosis of endophthalmitis has much improved with the advances of antibiotics and vitreoretinal surgery, of the number of patients that required evisceration or enucleation is still significant. We retrospectively reviewed the charts of 210 eyes of 210 patients with endophthalmitis andcompared the group that required evisceration or enucleation with those that received salvaging therapies. Regression analysis was used to identify the risk factors for evisceration or enucleation. Thirty eyes (14.3%) underwent enucleation or evisceration. The group of eviscerated or enucleated eyes were older (58.7 vs. 42.2 years, p < 0.001), had more women (56.7% vs. 22.2%, p = 0.003), had poorer initial visual acuity (2.79 vs. 2.10 LogMAR, p < 0.001), and had longer duration before intervention (18.03 vs. 5.74 days, p = 0.031). The most common primary indications for endophthalmitis were infections from corneal ulcer (50.0% vs. 4.4%, p < 0.001) andfrom endogenous source (23.3% vs. 5.6%, p < 0.001). Less common indications were trauma (26.7% vs. 67.8%, p < 0.001) and postoperative (6.7% vs. 22.2%, p = 0.049) endophthalmitis. After adjusting for confounding factors, corneal ulcer-related endophthalmitis, endogenous endophthalmitis and initial visual acuity were the independent risk factors for evisceration or enucleation.

Endogenous Endophthalmitis: A Review of Case Series Published between 2011 and 2020

“…The prognosis of EE is worse than in other types of endophthalmitis. In a retrospective study on all-cause endophthalmitis, EE was an independent risk factor for evisceration or enucleation [ 80 ].…”

A decade of surgical eye removals in Ontario: a clinical-pathological study

“…3,11 A significantly higher mean age in this group has also been noted in previous studies. 3,13,15 As there was no difference in ages between males and females, older age is more likely the significant factor, as immunosenescence may underlie the susceptibility of the older population to infections or immune pathologies. 39 Over the recent decade, glaucoma was found to be the most common pathology associated with eye removal.…”

“…Reports on enucleation patterns have come from the United States, 3,[7][8][9] Europe, [10][11][12][13][14] Asia, [15][16][17][18][19] Africa, [20][21][22][23][24] and the Middle East. [25][26][27] The clinical indications for and causes Crown Copyright & 2017 Published by Elsevier Inc on behalf of the Canadian Ophthalmological Society.…”

Histopathological spectrum of ophthalmic lesions in Chhattisgarh: study from a tertiary care centre

“…2 Ophthalmic pathologists study tissues excised by ophthalmologists through evisceration and enucleation and other ophthalmic biopsies. 3 The orbit is composed of the globe, extra ocular muscles, fat, vascular, nerve, glandular and connective tissues of neuroectodermal origin. 4 The neoplastic orbital lesions show wider range of pathological findings and further compounded by the patients' fear of loss of vision pose as a major challenge to ophthalmologists.…”