Treatment outcomes of post cataract surgery endophthalmitis in a tertiary referral center in Iran

Abstract

PurposeTo evaluate the treatment outcomes of patients with post cataract surgery endophthalmitis in our tertiary referral center.MethodsIn this prospective study, patients with presumed post cataract surgery endophthalmitis were treated based on the modified endophthalmitis vitrectomy study (EVS) guidelines and followed for at least three months. Visual and anatomical outcomes were assessed in the last follow-up visit.ResultsA total of 46 eyes with presumed post cataract surgery endophthalmitis were admitted to our hospital, of which 3 eyes with initial visual acuity of no light perception (NLP) and severe inflammation underwent primary evisceration. Forty-three patients were included to this study and followed up for at least three months. Culture results were positive in 51.2% of cases and streptococcus viridans was the most frequent isolated organism. Pars plana vitrectomy was performed in 16 eyes as primary treatment, and intravitreal antibiotic injection was done in 27 eyes. Re-treatment with pars plana vitrectomy was required in 15 eyes (34.9%). Best corrected visual acuity (BCVA) at final visit was 20/40 or better in 12 eyes (27.9%), between 20/200 to 20/40 in 17 eyes (39.5%), and worse than 20/200 in 14 eyes (32.6%). Evisceration was done in one eye (2.3%), and retinal detachment happened in 4 eyes (9.3%).ConclusionsThe visual outcomes of post cataract surgery endophthalmitis are generally poor. Our results in this study were comparable with many previous studies from other referral centers, however, unlike many reports, streptococcus viridans was the most common isolate in our study.

Pars Plana Vitrectomy in Post-Cataract Surgery Endophthalmitis in Cipto Mangunkusomo Hospital

“…14 reported a higher result of the improvement of final VA (20/40) reaching 51.8% after vitrectomy and intravitreal antibiotic injection. Other studies by Torabi et al 8 and Gower et al 18 reported final VA better than 6/60 after vitrectomy of 67.4% and 60%. This study shows the benefits of immediate vitrectomy to improve the final visual outcome even in cases with poor initial visual acuity.…”

“…3 The age range of post-cataract surgery endophthalmitis in this study was predominantly >60 years old (52.4%). Based on a study by Torabi et al 8 , it was found that the average age of postcataract surgery endophthalmitis patients were 68.7 years…”

Atypical Microbiological Feature of Infectious Endophthalmitis on Jeju Island: A 10-Year Study at a Single Tertiary Referral Center

“…The Endophthalmitis Vitrectomy Study indicated that Staphylococcus epidermidis was the most commonly isolated exogenous pathogen followed by Staphylococcus aureus , Streptococcus species, and Enterococcus species [ 33 ]. Other studies have also shown Staphylococcus epidermidis to be the most common pathogen [ 9 , 34 ] while Torabi et al [ 13 ] revealed that Streptococcus viridans was the most common pathogen. Kim et al [ 14 ] and Dave et al [ 15 ] reported that Pseudomonas aeruginosa was the most commonly isolated pathogen.…”

“…Streptococcus species, and Enterococcus species [33]. Other studies have also shown Staphylococcus epidermidis to be the most common pathogen [9,34] while Torabi et al [13] revealed that Streptococcus viridans was the most common pathogen. Kim et al [14] and Dave et al [15] introduced, and the sources of detection included blood, urine, sputum, swimming pools, and water tanks.…”

“…In postcataract endophthalmitis, Staphylococcus has been reported to be the most frequently isolated exogenous pathogen globally including in Korea [9][10][11][12]. In other studies, Streptococcus viridans and Pseudomonas aeruginosa were referred to as common exogenous pathogens of postcataract endophthalmitis [13][14][15]. In contrast, the fungus was found to be a common cause of postoperative endophthalmitis in tropical areas including India [16][17][18].…”