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22nd Annual Meeting of the German Retina Society

German Retina Society

26.06. - 27.06.2009, Berlin

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Endophthalmitis after Cataract surgery: vitrectomy without systemic antibiotics?

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  • Elena Margolina - University Eye Clinic of Luebeck
  • H. Hoerauf - University Eye Clinic of Goettingen
  • M. Müller - University Eye Clinic of Luebeck

German Retina Society. 22nd Annual Meeting of the German Retina Society. Berlin, 26.-27.06.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocRG2009-33

doi: 10.3205/09rg34, urn:nbn:de:0183-09rg345

This is the English version of the article.
The German version can be found at: http://www.egms.de/de/meetings/rg2009/09rg34.shtml

Published: June 29, 2009

© 2009 Margolina et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Background: Since the Endophthalmitis Vitrectomy Study the usefulness of systemic antibiotics for treatment of endophthalmitis after cataract surgery has been questioned.

Materials and Methods: Retrospective consecutive case series (1996–2008) of 40 patients (30 acute, 10 chronic endophthalmitis) after cataract surgery. Vitrectomy comprised: anterior chamber and vitreous tap, posterior capsulotomy, antibiotic solution (20µg/ml vancomycin, 80µg/ml amikacin, 40µg/ml dexamethason). Intraocular lens could be left in place in all cases. Postoperatively no systemic anbiotics were administered. Average follow-up was 15.7 months.

Results: Average best corrected visual acuity (VA) in 40 patients (19f, 21m, median age 76y) was 0.43 (0.45 logMAR), VA at last check after vitrectomy was 0.54 (0.36 logMAR). In cases of acute endophthalmitis, the average preoperative VA was 0.45 (0.45 logMAR) and final VA was 0.55 (0.41 logMAR). In cases of chronic endophthalmitis, the average preoperative VA was 0.39 (0.46 logMAR) and final VA was 0.52 (0.32 logMAR). Microbiologic studies yielded positive results in 19 patients (63.3%) with acute endophthalmitis. During the follow-up period 3 patients (2 chronic, 1 acute endopthalmitis) developed a recurrence; 2 patients suffered a retinal detachment.

Conclusions: In our patients both, with acute and chronic endophthalmitis, the functional and anatomical results of vitrectomy without systemic antibiotics were comparable to those of other studies in which additional antibiotics were given. Their usefulness and expense should therefore be questioned.