Prompt Pars Plana Vitrectomy for Exogenous Endophthalmitis May Bring Back Useful Function in More Than 60% of Cases


ABSTRACT

Between January1, 2012 ans December 31. 2016, we treated 16 cases of exogenous endophthalmitis with prompt pars plana vitrectomy and intraocular antibiotics. 10 cases occurred after intravitreal injection of anti-VEGF, 5 after cataract surgery and 1 after traumatic rupture of a PKP. 14 of the postoperative cases presented either acutely with symptoms within 3 days after surgery or subacutely within 1 week after surgery, only 1 case delayed after 2 weeks. All patients underwent prompt pars plana vitrrectomy on the day of their presentation at the hospital, with intravitreal vancomycin and 4th generation cephalosporine (ceftazidine). Postoperatively antibiotic treatment was continued with topical ofloxacine, high doses of topical and sometimes subconjunctival steroids and systemic vancomycin and cephalosporine until clinical resolution of the inflammation (3 – 7days). The development of visual acuity was calculated after transforming Snellen values into LogMAR values. Mean visual acuity at admittance was finger counting (LogMAR 1.9), at last follow up 20/60 (LogMAR 0.55). Reading ability (VA 20/50 or better) was regained in 10 eyes (63%), mean gain of visual acuity was 34 fold. In conclusion, prompt pars plana vitrectomy combined with intravitreal injections of vancomycin and cephalosporine could prevent blindness of loss of the eye in all cases and could bring back reasonable function in more than 60%.


CONTACT DETAILS

 

Wolfgang F Schrader
Wuerzburg, Germany
Email : mail@profschrader.de
Cell Phone: +4915140445451
Work Phone: +49931452000