Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1992 Jul;76(7):419–423. doi: 10.1136/bjo.76.7.419

Endophthalmitis following extracapsular cataract surgery: a review of 32 cases.

C J Heaven 1, P J Mann 1, D L Boase 1
PMCID: PMC504303  PMID: 1627512

Abstract

Thirty two cases of endophthalmitis following extracapsular cataract surgery that had occurred within our department and had undergone intraocular diagnostic tap between May 1982 and May 1991 were reviewed. An infectious agent was identified in 20 cases (62.5%). The commonest organism was Staphylococcus epidermidis (11 cases) (55%). Proteus was the only gram negative organism identified (four cases) (20%). Both of these organisms were associated with a favourable visual outcome. In the culture positive subgroup 15 eyes (75%) achieved a final acuity of 6/60 or better with 10 eyes (50%) gaining 6/12 or better. Thirteen (65%) of the culture positive cases were managed without vitreal intervention. Of these 11 (85%) achieved 6/60 or better with eight (62%) gaining 6/12 or better. It appears that when an endophthalmitis follows uncomplicated extracapsular cataract surgery delivery of antibiotic by the 'conventional' routes (topical, subconjunctival and systemic) is consistent with a favourable visual result in many cases. A modified anterior chamber diagnostic tap technique is described.

Full text

PDF
419

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Axelrod J. L., Newton J. C., Klein R. M., Bergen R. L., Sheikh M. Z. Penetration of imipenem into human aqueous and vitreous humor. Am J Ophthalmol. 1987 Dec 15;104(6):649–653. doi: 10.1016/0002-9394(87)90180-2. [DOI] [PubMed] [Google Scholar]
  2. Beyer T. L., Vogler G., Sharma D., O'Donnell F. E., Jr Protective barrier effect of the posterior lens capsule in exogenous bacterial endophthalmitis--an experimental primate study. Invest Ophthalmol Vis Sci. 1984 Jan;25(1):108–112. [PubMed] [Google Scholar]
  3. Beyer T. L., Vogler G., Sharma D., O'Donnell F. E., Jr Protective barrier effect of the posterior lens capsule in exogenous bacterial endophthalmitis: an experimental pseudophakic primate study. J Am Intraocul Implant Soc. 1983 Summer;9(3):293–296. doi: 10.1016/s0146-2776(83)80058-5. [DOI] [PubMed] [Google Scholar]
  4. Bodé D. D., Jr, Gelender H., Forster R. K. A retrospective review of endophthalmitis due to coagulase-negative staphylococci. Br J Ophthalmol. 1985 Dec;69(12):915–919. doi: 10.1136/bjo.69.12.915. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bohigian G. M., Olk R. J. Factors associated with a poor visual result in endophthalmitis. Am J Ophthalmol. 1986 Mar 15;101(3):332–341. doi: 10.1016/0002-9394(86)90829-9. [DOI] [PubMed] [Google Scholar]
  6. Brown G. C., Eagle R. C., Shakin E. P., Gruber M., Arbizio V. V. Retinal toxicity of intravitreal gentamicin. Arch Ophthalmol. 1990 Dec;108(12):1740–1744. doi: 10.1001/archopht.1990.01070140094037. [DOI] [PubMed] [Google Scholar]
  7. Carlson A. N., Tetz M. R., Apple D. J. Infectious complications of modern cataract surgery and intraocular lens implantation. Infect Dis Clin North Am. 1989 Jun;3(2):339–355. [PubMed] [Google Scholar]
  8. Diamond J. G. Intraocular management of endophthalmitis. A systematic approach. Arch Ophthalmol. 1981 Jan;99(1):96–99. doi: 10.1001/archopht.1981.03930010098011. [DOI] [PubMed] [Google Scholar]
  9. Driebe W. T., Jr, Mandelbaum S., Forster R. K., Schwartz L. K., Culbertson W. W. Pseudophakic endophthalmitis. Diagnosis and management. Ophthalmology. 1986 Apr;93(4):442–448. doi: 10.1016/s0161-6420(86)33722-9. [DOI] [PubMed] [Google Scholar]
  10. Eichenbaum D. M., Jaffe N. S., Clayman H. M., Light D. S. Pars plana vitrectomy as a primary treatment for acute bacterial endophthalmitis. Am J Ophthalmol. 1978 Aug;86(2):167–171. doi: 10.1016/s0002-9394(14)76806-0. [DOI] [PubMed] [Google Scholar]
  11. Ficker L., Meredith T. A., Gardner S., Wilson L. A. Cefazolin levels after intravitreal injection. Effects of inflammation and surgery. Invest Ophthalmol Vis Sci. 1990 Mar 1;31(3):502–505. [PubMed] [Google Scholar]
  12. Ficker L., Peacock J. Infectious endophthalmitis. Trans Ophthalmol Soc U K. 1986;105(Pt 3):319–323. [PubMed] [Google Scholar]
  13. Forster R. K., Abbott R. L., Gelender H. Management of infectious endophthalmitis. Ophthalmology. 1980 Apr;87(4):313–319. doi: 10.1016/s0161-6420(80)35241-x. [DOI] [PubMed] [Google Scholar]
  14. Forster R. K. Endophthalmitis. Diagnostic cultures and visual results. Arch Ophthalmol. 1974 Nov;92(5):387–392. doi: 10.1001/archopht.1974.01010010399005. [DOI] [PubMed] [Google Scholar]
  15. Forster R. K. Etiology and diagnosis of bacterial postoperative endophthalmitis. Ophthalmology. 1978 Apr;85(4):320–326. doi: 10.1016/s0161-6420(78)35663-3. [DOI] [PubMed] [Google Scholar]
  16. Lesar T. S., Fiscella R. G. Antimicrobial drug delivery to the eye. Drug Intell Clin Pharm. 1985 Sep;19(9):642–654. doi: 10.1177/106002808501900905. [DOI] [PubMed] [Google Scholar]
  17. Meisler D. M., Palestine A. G., Vastine D. W., Demartini D. R., Murphy B. F., Reinhart W. J., Zakov Z. N., McMahon J. T., Cliffel T. P. Chronic Propionibacterium endophthalmitis after extracapsular cataract extraction and intraocular lens implantation. Am J Ophthalmol. 1986 Dec 15;102(6):733–739. doi: 10.1016/0002-9394(86)90401-0. [DOI] [PubMed] [Google Scholar]
  18. Nirankari V. S., Karesh J. W., Lakhanpal V., Schocket S. S. Pseudophakic endophthalmitis. Ophthalmic Surg. 1983 Apr;14(4):314–316. [PubMed] [Google Scholar]
  19. O'Day D. M., Jones D. B., Patrinely J., Elliott J. H. Staphylococcus epidermidis endophthalmitis. Visual outcome following noninvasive therapy. Ophthalmology. 1982 Apr;89(4):354–360. [PubMed] [Google Scholar]
  20. Olson J. C., Flynn H. W., Jr, Forster R. K., Culbertson W. W. Results in the treatment of postoperative endophthalmitis. Ophthalmology. 1983 Jun;90(6):692–699. doi: 10.1016/s0161-6420(83)34511-5. [DOI] [PubMed] [Google Scholar]
  21. Ormerod L. D., Paton B. G., Haaf J., Topping T. M., Baker A. S. Anaerobic bacterial endophthalmitis. Ophthalmology. 1987 Jul;94(7):799–808. doi: 10.1016/s0161-6420(87)33532-8. [DOI] [PubMed] [Google Scholar]
  22. Peyman G. A., May D. R., Ericson E. S., Apple D. Intraocular injection of gentamicin. Toxic effects of clearance. Arch Ophthalmol. 1974 Jul;92(1):42–47. doi: 10.1001/archopht.1974.01010010046011. [DOI] [PubMed] [Google Scholar]
  23. Peyman G. A., Raichand M., Bennett T. O. Management of endophthalmitis with pars plana vitrectomy. Br J Ophthalmol. 1980 Jul;64(7):472–475. doi: 10.1136/bjo.64.7.472. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Puliafito C. A., Baker A. S., Haaf J., Foster C. S. Infectious endophthalmitis. Review of 36 cases. Ophthalmology. 1982 Aug;89(8):921–929. [PubMed] [Google Scholar]
  25. Rowsey J. J., Newsom D. L., Sexton D. J., Harms W. K. Endophthalmitis: current approaches. Ophthalmology. 1982 Sep;89(9):1055–1066. doi: 10.1016/s0161-6420(82)34691-6. [DOI] [PubMed] [Google Scholar]
  26. Sherwood D. R., Rich W. J., Jacob J. S., Hart R. J., Fairchild Y. L. Bacterial contamination of intraocular and extraocular fluids during extracapsular cataract extraction. Eye (Lond) 1989;3(Pt 3):308–312. doi: 10.1038/eye.1989.44. [DOI] [PubMed] [Google Scholar]
  27. Smith R. T., Campbell C. J., Koester C. J., Trokel S., Anderson A. The barrier function in extracapsular cataract surgery. Ophthalmology. 1990 Jan;97(1):90–95. [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES