Intracapsular and extracapsular pseudophakic endophthalmitis: a comparison

A hundred and four cases of post cataract endophthalmitis with positive vitreous cultures are discussed. Functional results depend largely on the infecting agent but even after Staphylococcus epidermidis infections some eyes may be lost. Although post lens surgery endophthalmitis carries the best prognosis in the endophthalmitis group, 40% of the eyes are lost, sometimes caused by a delayed vitrectomy decision. Comparing intracapsular and extracapsular lens surgery two big differences were noted: (1) the bacteriology, and (2) the functional results. The bacteriological spectrum of the ICCE was composed of 1/3 of S. epidermidis, 70% of Gram + cocci and 80% of Gram + organisms. After extracapsular lens extraction the majority of cases (60%) were caused by S. epidermidis (statistical significance 0,01). The difference in functional result is explained by the difference in bacteriology: if only the S. epidermidis cases are compared, functional results between both categories are nearly equal. ECCE seems to make the eye more vulnerable to infection by a low virulent agent

Endophthalmitis after lens extraction

This article describes most features of endophthalmitis after lens extraction: symptomatology, differential diagnosis, prognosis, treatment and prevention. Literature findings are compared to the author's proper extensive experience with endophthalmitis. Cultures have been positive in 153 cases. A hundred and fifteen of them were seen after previous ocular surgery. Amongst these cases 104 were seen after cataract surgery

Bacteriological study of 92 cases of proven infectious endophthalmitis treated with pars plana vitrectomy

92 cases of proven infectious endophthalmitis underwent pars plana vitrectomy first to identify the responsible agent and directing the antibiotherapy, second to remove the absces and third to make room for intravitreal injection of antibiotics. A wide spectrum of organisms was isolated (16 different agents). Prognosis of endophthalmitis depends on (1) the responsible agent and (2) the reason for developing the endophthalmitis. The prognosis after lens implantation was rather favorable, whereas after vitrectomy the results were disastrous. Good results were obtained if the infecting agent was Staphylococcus epidermidis. Results after Streptococcus, Staphylococcus aureus, Bacillus or Pneumococcus were bad. Of the mycotic cases, only half of the Candida cases were cured. Other mycotic infections had a worse outcome