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K. Alliman, H. W. Flynn, Jr., G. Lalwani, C. Quinn, J. L. Davis, T. G. Murray, P. Rosenfeld, W. E. Smiddy; Acute-Onset Endophthalmitis Following Clear Corneal Cataract Surgery: A 12-Year Review (1996-2008). Invest. Ophthalmol. Vis. Sci. 2009;50(13):3564.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical features, causative organisms and visual acuity outcomes associated with endophthalmitis following clear corneal cataract surgery.
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.
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.
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.
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