Study of panophthalmitis after cataract surgery from 1997 to 1999

Purpose: To define the clinical outcome and microbiological pattern of bact erial endophthalmitis that were referred at the lutes Gonin Eye Hospital fr om January 1997 to September 1999. Methods: Patients were recorded in a computerised databank and were managed according to a standard protocol. An anterior chamber tap combined with a vitreous biopsy by the pars plana was performed in all patients. The treatm ent included an intravitreal injection of 1 mg Vancomycin and 400 mu g Amik acin diluted in 0.2 ml NaCl 0.9%. Postoperatively hourly therapy Cefazolin 50 mg/ml and Garamycin 9 mg/ml was applied. To determine possible risks fac tors a standard form was sent to all referring surgeons. The following data were analysed: delay of onset, risk factors, initial and final visual acui ty. Results: From January 1997 to September 1999, 31 patients were referred. 18 /31 (58%) of the cases were admitted between April and June of each years. The mean age was of 75 +/- 10 years, initial visual acuity ranged from ligh t perception to 20/ 40. 17/31 of the patient's cultures were positive. The major pathogen were Staphylococcus epidermidis in 9/31 patients and Staphyl ococcus aureus in 4/31 patients. No correlation between the endophthalmitis and the surgical technique or perioperative management of the patient, cou ld be determined. Visual outcome was significantly improved in 56,7% of the patients. Conclusions: The severity of outcome could be correlated to the type of bac teria isolated. The high prevalence of panophthalmitis from March to June s uggests that a climatic factors may be involved in its pathogenesis.