A prospective and nationwide study investigating endophthalmitis following pars plana vitrectomy: clinical presentation, microbiology, management and outcome

Abstract

Background/aims: This is the first prospective and nationwide study aiming to provide epidemiological data relating to presentation, microbiology, management and outcome of endophthalmitis following vitrectomy.

Methods: Two years of prospective and nationwide surveillance for cases of presumed infectious endophthalmitis within 6 weeks of pars plana vitrectomy was completed. The study obtained case reports via the established British Ophthalmological Surveillance Unit (BOSU) system.

Results: Thirty-seven cases were reported and 28 met the diagnostic criteria for presumed infectious endophthalmitis following vitrectomy. Mean age was 61 years and 67% were male. Nineteen cases were 23/25 gauge and 9 cases were 20 gauge. Mean time from surgery to endophthalmitis was 5 days. Blurred vision (85.2%), pain (77.8%) and a hypopyon (77.8%) were the commonest presenting symptoms and signs. Seventeen cases (60.7%) had a positive culture. Culture-positive endophthalmitis, relative to culture-negative endophthalmitis, was no different with respect to time to presentation, symptoms, signs or outcome. Outcome was poor, with 29.6% of eyes being eviscerated or having no perception of light or perception of light.

Conclusions: This study helps surgeons promptly identify cases of endophthalmitis following vitrectomy and informs them about the various management options currently used and the likely outcome of this devastating complication.

Keywords: Epidemiology; Infection; Microbiology; Retina; Treatment Surgery.