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. 2025 Aug;14(8):2031-2042.
doi: 10.1007/s40123-025-01196-x. Epub 2025 Jul 9.

Early Vitrectomy in Endophthalmitis: Visual Outcomes and Complication Rates

Julian W Sromicki  1 , Marc Stahel  1 , Robert A Blum  1 , Katrin A Rudolph  1 , Daniel Barthelmes  2   3
Affiliations

Early Vitrectomy in Endophthalmitis: Visual Outcomes and Complication Rates

Julian W Sromicki et al. Ophthalmol Ther. 2025 Aug.

Abstract

Introduction: This study examined visual outcomes and complication rates after early pars plana vitrectomy (PPV) in eyes with endophthalmitis.

Methods: The study was designed as a single-center, retrospective, observational database study. A total of 92 eyes treated with early PPV for endophthalmitis at the University Hospital Zurich between 2006 and 2016 were included. Endophthalmitis cases following cataract surgery (CAT, n = 44), intravitreal injection (IVI, n = 12), trabeculectomy (TRAB, n = 6), and Others (e.g., trauma or endogenous, n = 30) were assessed. Visual acuity (VA) and intraocular pressure (IOP) from prior to endophthalmitis to 12 months after PPV were analyzed. Secondary outcomes included complications following the procedure.

Results: CAT and IVI groups showed good visual outcomes. Final VA in CAT and IVI groups was not statistically different to prior to endophthalmitis (CAT p = 0.840, IVI p = 0.933). In the CAT group, 78.9% of eyes with a starting VA of > light perception achieved ≥ 20/40 final VA. The highest rate of patients with at least one complication was observed in TRAB (100%), followed by Others (63.3%), IVI (50.0%), and CAT groups (40.9%).

Conclusion: Early PPV may be beneficial in endophthalmitis following cataract surgery and intravitreal injection, regardless of initial VA.

Keywords: Cataract surgery; Complication rate; Endophthalmitis; Endophthalmitis vitrectomy study (EVS); Intraocular pressure; Intravitreal injections; Trabeculectomy; Visual outcome; Vitrectomy.

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Conflict of interest statement

Declarations. Conflict of Interest: Julian W Sromicki, Marc Stahel, Robert A, Katrin A Rudolph, and Daniel Barthelmes have no financial/conflicting interests to disclose. Ethical Approval: All patients included in the study provided their consent for their data to be published in anonymized form. Ethical approval for the study was obtained from the Cantonal Ethics Committee, Zurich. This study was conducted in accordance with the Declaration of Helsinki (1964) and its later amendments.

Figures

Fig. 1
Fig. 1
Flowchart patient recruitment (PPV pars plana vitrectomy)
Fig. 2
Fig. 2
Course of visual acuity (logMAR). VA visual acuity, CAT cataract surgery, IVI intravitreal injection, TRAB trabeculectomy
Fig. 3
Fig. 3
Course of IOP (IOP intraocular pressure; mmHg). CAT cataract surgery, IVI intravitreal injection, TRAB trabeculectomy
See this image and copyright information in PMC

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