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H. Mino de Kaspar, C. Schulze-Doebold, Y. A. Yactayo Miranda, A. Gandorfer,, A. Kampik; Postoperative Endophthalmitis: Incidence and Prognosis Over a 5 Year Survey. Invest. Ophthalmol. Vis. Sci. 2007;48(13):696.
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To determine the incidence and outcomes of all patients treated for endophthalmitis at the Department of Ophthalmology, Ludwig-Maximilians University over the past 5 years.
A retrospective review was conducted of all cases of postoperative endophthalmitis from January 2002-November 2006. After IRB approval was granted, a comprehensive list of 47 patients (47 eyes) treated for endophthalmitis since 2002 was gathered from the microbiology laboratory. Patients’ medical records were then obtained and reviewed, classifying each as either in-patient (primary surgery in our ospital) or out-patient (referred) and acute or delayed onset endophthalmitis. The incidence of postoperative endophthalmitis was determined for in-patients, and the following data were analyzed for all patients: age, gender, primary surgery performed, microorganisms isolated, source of microorganisms, treatment modality, clinical presentation, and final visual acuity.
Of the 47 endophthalmitis cases, 12 arose after a surgery performed at our institution. The overall incidence of postoperative endophthalmitis was 0.065% over a 5-years period (12/18,994). All 12 in-patients were acute onset, while 27 out-patients were acute and 8 were delayed onset endophthalmitis. Thirty of the 47 (64%) patients had a microorganism cause of endophthalmitis identified. Of these, the most common was coagulase-negative Staphylococcus, 17 (36%), followed by Streptococci, 8 (17%), both groups had bacteria that were multiresistant to the common antibiotics, but every bacteria was sensitive to vancomycin and imipenem. The other patients had S. aureus 2 (4.2%) filamentous fungi, 3 (6.4%), sterile 10 (21%), and there were 7 cases (15%) without this data. Therapy and visual outcome see Table 1.
The incidence of endophthalmitis remained stable over the last 10 years. Visual improvement was statistically significant in all groups, probably due to the combination of vitreous surgery and various antimicrobial medications.
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