Acute-Onset Endophthalmitis Following Clear Corneal Cataract Surgery: A 12-Year Review (1996-2008)

Abstract

Purpose: : To report the clinical features, causative organisms and visual acuity outcomes associated with endophthalmitis following clear corneal cataract surgery.

Methods: : A retrospective, observational consecutive cases series between January 1, 1996 and September 1, 2008. Acute-onset endophthalmitis cases following clear corneal surgery were identified by a review of microbiological and clinical records. Patients with clinically diagnosed and culture-positive endophthalmitis occurring within 6 weeks of clear corneal cataract surgery were included in the current study.

Results: : The study included 105 eyes of 105 patients. The mean age was 76 years. Visual acuity was less than 20/200 at presentation in 93% of patients. Hypopyon was present in 82%. The mean time to diagnosis was 13 days. The initial treatment was intravitreal antibiotics for all patients; vitreous tap and intravitreal injection was performed in 75% of eyes and pars plana vitrectomy in 25%. Coagulase negative Staphylococcus was isolated in 66% of patients. Other isolates included Staphylococcus aureus 7% and Streptococcus species in 8%. All gram positive isolates were sensitive to vancomycin. A visual acuity of 20/40 or better was achieved in 49% of eyes at their final follow-up.

Conclusions: : In this series, the mean time from surgery to diagnosis was slightly less than two weeks. Coagulase negative Staphylococcus was the most common isolate. Approximately half of the patients achieved 20/40 or better vision after treatment of endophthalmitis.

Keywords: endophthalmitis • cataract