Surgical Management of Infectious Endophthalmitis: Early Vitrectomy vs Late Vitrectomy

Suh, Dong Suk; Roh, Joo Heon; Kim, Shin Dong

Abstract

Authors investigated the effect of the timing of vitrectomy for endophthalmitis on the final visual acuity, by retrospectively reviewing the clinical records of patients who have undergone pars plana vitrectomy for the treatment of endophthalmitis from Feb. 1990. Twenty one cases(21 eyes) were included who were followed up for 6 months or longer after surgery and intravitreal injection of antibiotics. 14 cases were male. The age ranged from 28 to 81 years, with mean age of 40.5 years. Ten cases arose from intraocular surgeries, with 7 cases of early-onset and 3 cases of late-onset, the other 10 cases were related to ocular trauma and the remaining one case was associated with a filtering bleb. Intravitreal injections, subconjunctival injections and topical eye instillation of antibiotics were preformed as an initial treatments on cases whose retina were invisible due to severe inflammatory media opacities. Those cases who did not respond to initial treatments were divide into two groups: one which underwent early vitrectomy within 2 days, and the other which underwent late vitrectomy after 2 days. Ten out of 12 cases among early vitrectomy group and 3 out of 9 cases among late vitrectomy group obtained final vision of 0.1 or better. The cases which underwent early vitrectomy showed good visual prognosis with statistical significance(P<0.05). Therefore, authors suggest that management of endophthalmitis with initial severe inflammatory reactions should include early diagnosis, and early vitrectomy with intravitreal infection of antibiotics for recovery of maximal visual acuity.