Vitreoretinal interface changes in acute-onset postoperative endophthalmitis

Abstract

Background: The aim of this study was to assess the significance of different clinical appearances of the vitreoretinal interface in the surgical management of acute postoperative endophthalmitis.

Patients and methods: 22 patients underwent vitrectomy and were divided intraoperatively in 3 groups according to the degree of vitreoretinal interface changes: 10 patients had white infiltrates in the vitreous cortex but no retinal hemorrhages (group A), eight patients had white infiltrates in the vitreous cortex and retinal hemorrhages (group B) and four patients had advanced vitreous opacification, strong vitreoretinal adhesions and retinal hemorrhages (group C). In group A vitrectomy was performed and the vitreous cortex was removed cautiously, while in groups B and C the vitreous cortex was not removed in the first procedure.

Results: Visual acuity improved in 14 patients, remained stable in 2 patients and deteriorated in 6 patients. The visual prognosis was better in group A. None of the cases was complicated with retinal detachment following vitrectomy, but in groups B and C 37.5 % and 50 % of the patients, respectively, went into phthisis.

Conclusions: Intraoperative assessment of the vitreoretinal interface insult in acute postoperative endophthalmitis contributes to an optimal surgical management, and it also has a prognostic value.