Purpose
Profound, permanent vision loss is common in patients with endophthalmitis. The purpose of this case series was to identify the primary causes of endophthalmitis that required surgical treatment with vitrectomy and evaluate visual outcomes at a large tertiary care institution.
Methods
A retrospective review of patients with CPT code 67036 for pars plana vitrectomies over a ten year period (2004-2013) at a single institution was performed. These patients were cross referenced with the ICD-9 code 360 for endophthalmitis. Underlying diagnosis, demographic information, clinical presentation, and ophthalmic findings were recorded.
Results
A total of sixteen patients were identified. Underlying etiologies included post cataract extraction in seven patients (44%), post injection in two (13%), post glaucoma drainage device in two (13%). A single patient developed endophthalmitis from the following etiologies: a combined cataract/glaucoma surgery, toxoplasmosis, acute retinal necrosis, lymphoma, traumatic globe rupture, and endogenous infection. Final visual acuity was finger counting or worse in 6 /11(55%), and 20/70 or better in only 2/11 (18%) for which data was available. A single patient had the eye enucleated and two eyes were no light perception at most recent follow up.
Conclusions
Endophthalmitis following glaucoma drainage implants is a rare and visually devastating disease. In all three patients with endophthalmitis following glaucoma drainage implantation, vision was no light perception or resulted in enucleation. A single patient s/p combined cataract extraction and trabeculectomy had VA 20/70 and a single post operative patient had 20/25 final visual acuity. This case series stresses the differences in visual outcomes by etiology for endophthalmitis requiring vitrectomy.
Keywords: 513 endophthalmitis