Clinical Outcome of Post-Cataract Surgery Endophthalmitis Using Oral Ciprofloxacin

Abstract

Purpose: : To report on the clinical outcome of post-cataract surgery endophthalmitis using oral ciprofloxacin.

Methods: : Retrospective review of charts of patients seen with acute infectious endophthalmitis following cataract surgery was done. Pre-operative symptoms, visual acuity and clinical findings were recorded. Treatment methods including oral ciprofloxacin, intravitreal injection of antibiotics and vitrectomy were noted. Clinical outcome and final visual acuity were documented.

Results: : A total of 11 eyes from 11 patients were identified (3 men and 8 women). Vision at presentation ranged from 20/60 to light perception. Most patients presented with pain, hypopyon and vitritis. All patients were treated with oral ciprofloxacin 500mg twice daily. Six had no other treatment initially. Four patients had concurrent vitrectomy with intravitreal injection of antibiotics. One patient had concurrent vitreous tap for culture and intravitreal injection of antibiotics (tap and inject). Of the six patients who had no additional treatment initially, the pre-operative vision ranged from 20/80 to hand movement. Four of them were cleared of infection with a final Snellen visual acuity of 20/20 to 20/200. Two patients had worsening clinical signs within 2 days of treatment and were taken to vitrectomy with a final visual acuity of 20/25 and 20/100.

Conclusions: : Patients with a milder form (better than light perception) of post-cataract surgery endophthalmitis may be effectively treated with ciprofloxacin alone without intravitreal injection of antibiotics. Cases that fail with ciprofloxacin treatment may be effectively rescued with subsequent vitrectomy.

Keywords: endophthalmitis • cataract • antibiotics/antifungals/antiparasitics