To determine(1) which technique of microbiologic diagnosis is most effective, (2) whitch antibiotics are drugs of choice for initial intravitreal antibiotics, and (3) which factors influence visual outcome of endophthalmitis, the medical records
of
32
patients(32 eyes) with infectious endophthalmitis who were treated at our institution between September 1989 and September 1993 were reviewed. Pars plana vitrectomy was performed in 30 eyes, along with intraocular antibiotics injection. A sample
of
vitreous diluted by the irrigating solution was passed through a disposable membrane filter system and inoculated into the blood-culture bottle.
In 31(97%) of 32 eyes, microorganisms were identified. The most frequent pathogen was Staphylococcus epidermidis(28.9%). Vancomycin and Amikacin were considered the drugs of choice for initial intravitreal antibiotics. There was no difference in
visual
outcome between etiologic categories. Eyes with endophthalmitis developed between 4 days and 4 months after inoculating event have better visual prognosis than those with earlier onset(p=0.022), Overall, 17(53%) of 32 patients achieved a visual
acuity
of 20/400 or better. Postoperative complications included retinal detachment(5 eyes), glaucoma, recurrence of endophthalmitis and macular degeneration. For effective management of infectious endophthalmitis, we recommend the use of membrane
filter
system and blood-culture bottle and prompt initiation of broad-spectrum intravitreal antibiotics(Vancomycin and Amikacin), along with vitrectomy if necessary.
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