In a group of 615 cases of perforating trauma, 25 cases (4%) of proven endophthalmitis were seen. The percentage of Bacillus infections was unusually high compared to other types of endophthalmitis (3.8% for the whole group, 31% for the group with intraocular foreign bodies). Bacillus cases have a very poor outcome and in fact the overall functional results in the post-traumatic endophthalmitis group were poorer than in other categories.
92 cases of proven infectious endophthalmitis underwent pars plana vitrectomy first to identify the responsible agent and directing the antibiotherapy, second to remove the absces and third to make room for intravitreal injection of antibiotics. A wide spectrum of organisms was isolated (16 different agents). Prognosis of endophthalmitis depends on (1) the responsible agent and (2) the reason for developing the endophthalmitis. The prognosis after lens implantation was rather favorable, whereas after vitrectomy the results were disastrous. Good results were obtained if the infecting agent was Staphylococcus epidermidis. Results after Streptococcus, Staphylococcus aureus, Bacillus or Pneumococcus were bad. Of the mycotic cases, only half of the Candida cases were cured. Other mycotic infections had a worse outcome.
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