Abstract
Abstract: :
Purpose: To determine risk factors for poor visual outcome in postoperative endophthalmitis. Methods: Two hundred six patients with postoperative endophthalmitis seen at LV Prasad Eye Institute in Hyderabad, India between 1991-1997 were prospectively examined. A detailed protocol was followed, and all included patients were followed-up for a minimum of 3 months. Chi-square and logistic regression analysis was used to determine risk factors for visual outcome worse than 20/60 and worse than 20/400. Results: In the univariate analysis, clinical presentation features associated with poor visual acuity (grouped as <20/60 and <20/400) included a history of ICCE surgery, poor visual acuity at presentation, the presence of vitreous exudate, inability to visualize the optic disc on indirect ophthalmoscopy, the presence of vitreous membranes on ultrasonography, and a culture-positive vitreous biopsy. In the multivariate analysis, visual acuity of ≤LP at presentation was associated with a 3-month postoperative visual acuity of <20/60, with an odds ratio of 5.85 [1.25 - 27.42, 95% CI], and vitreous membranes seen on ultrasonography was associated with a final visual acuity of <20/400, with an odds ratio of 2.47 [1.05 - 5.83, 95% CI]. Conclusion: We have found that an initial visual acuity of ≤LP is an independent risk factor for 3-month follow-up visual acuity of <20/60, and that the presence of vitreous membranes on ultrasonography is an independent risk factor for 3-month visual acuity of <20/400.
Keywords: 398 endophthalmitis • 355 clinical (human) or epidemiologic studies: risk factor assessment • 620 visual acuity