THE TREATMENT OF ENDOPHTHALMITIS AFTER CATARACT-SURGERY - REVIEW OF 26 CASES

A retrospective study of 26 cases of postoperative endophthalmitis occ urring after extracapsular cataract extraction and lens implantation w as conducted between January 1989 and December 1992. Twenty-one of the 26 cases (81 %) were diagnosed within two weeks after surgery. The mo st common organism isolated was Staphylococcus saprophyticus (23 %). A fter the bacterial samples had been taken, cefotaxime or gentamicin wa s injected into anterior chamber and vitreous space. The therapy regim en consisted of topical tobramycin, Polysporin(R) (polymyxinsulfate, n eomycinsulfate and gramicidin), dexamethasone and atropine and parabul bar cefotaxime, netilmicin and betamethasone. Cefotaxime or, alternati vely, clindamycin, ciprofloxacin and prednisolone were given systemica lly. The final visual acuity of 20/40 or more was obtained in 15 cases (58 %). Twenty-one patients (81 %) achieved a visual acuity of 20/400 or better. Three patients had no light perception after the treatment of endophthalmitis. Silk as suture material in wound closure and rupt ure of the posterior capsule were found to be risk factors in the deve lopment of endophthalmitis. The results of the present study show that effective drug treatment also results in good visual outcome.