Endophthalmitis and pars plana vitrectomy.

A review of all cases of suspected endophthalmitis following cataract extraction seen at one referral hospital between 1979 and 1983 was conducted. Of the 13 cases, 7 were proven by culture to be bacterial endophthalmitis when organisms were grown from aspirates of the aqueous, the vitreous or both. Antibiotic therapy was administered by intravitreal, periocular, topical and systemic routes. In some cases vitrectomy was performed immediately after the diagnostic aspiration or within 24 hours. Poor visual outcome was associated with a long interval between onset of symptoms and admission to hospital, expulsive hemorrhage, retinal detachment or resistance of the microorganism to the intraocularly administered antibiotic. The two eyes that yielded gentamicin-resistant Streptococcus viridans and ended up with no light perception demonstrate the need for simultaneous intravitreal injection of two antibiotics.