Primary Vitrectomy (MIVS) for Resistant-pseudomonas Cluster Endophthalmitis: Consecutive Nine Surgeries on a Single Day



To demonstrate the surgical techniques and describe outcomes of 23-G vitrectomy in acute cluster endophthalmitis.


Nine eyes with acute post-cataract endophthalmitis (1 days) underwent primary 23-G vitrectomy with meticulous anterior chamber (AC) cleaning and intravitreal antibiotics on the same day in a single operative session.


Presenting visual acuities in all eyes ranged from light perception to hand movement. All eyes demonstrated severe vitritis (+4), 7 had hypopyon, and 5 eyes had significant AC fibrin and corneal involvement with almost no view of posterior segment. Two eyes had primary silicone oil. Four eyes needed repeat intravitreal injections after primary vitrectomy. Three eyes needed repeat vitrectomy, two needing silicone oil injection. After 6 years follow-up, all eyes showed complete resolution of inflammation and visual acuity improved to 20/63 or better in 7/9 eyes (range: 20/200-20/32). In no case was simultaneous intraoperative keratoprosthesis required to manage the cases.


Primary 23-G vitrectomy surgery is effective in severe acute postoperative cluster endophthalmitis, even in cases with severe corneal involvement without keratoprosthesis. Primary silicone oil may be effective in most severe cases to have a better control of the inflammation



Alay S. Banker
Ahmedabad, India
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