ENDOPHTHALMITIS - INCIDENCE, THERAPY AND VISUAL OUTCOME IN THE PERIOD1983-1992 IN THE ROTTERDAM-EYE-HOSPITAL

From 1983 to 1992, 134 patients were treated for clinically suspected endophthalmitis. 61% of this endophthalmitis population consisted of c ases that were referred to our clinic. In this nine year period antibi otic treatment was carried out according to three consecutively used g uidelines. These three treatment schemes differed in antibiotic spectr um and mode of antibiotic delivery. In 68 patients we performed vitrec tomy on account of clinical deterioration under antibiotic treatment. We did not find significant differences in visual outcome between the three treatment groups. The incidence of endophthalmitis following cat aract or vitreous surgery did not change throughout the study period. There was however a dramatic decrease in incidence of post-traumatic e ndophthalmitis following the introduction of a profylactic antibiotic treatment scheme consisting of fortified gentamicin and cefazolin eyed rops, and intravenously and subconjunctivally administered gentamicin, cefazolin, and clindamycin. In 55 of 68 cases in which vitrectomy was performed in conjunction with intravitreal antibiotics, a vitreous or anterior chamber specimen was cultured. 36 patients had a positive cu lture result. In the group with positive culture result 42% had better visual acuity in the post-treatment period than before treatment. In the group with a sterile culture result 79% had better vision after tr eatment.