Treatment outcomes of post cataract surgery endophthalmitis in a tertiary referral center in Iran

Purpose: To evaluate the treatment outcomes of patients with post cataract surgery endophthalmitis in our tertiary referral center. Methods: In this prospective study, patients with presumed post cataract surgery endophthalmitis were treated based on the modified endophthalmitis vitrectomy study (EVS) guidelines and followed for at least three months. Visual and anatomical outcomes were assessed in the last follow-up visit. Results: A total of 46 eyes with presumed post cataract surgery endophthalmitis were admitted to our hospital, of which 3 eyes with initial visual acuity of no light perception (NLP) and severe inflammation underwent primary evisceration. Forty-three patients were included to this study and followed up for at least three months. Culture results were positive in 51.2% of cases and streptococcus viridans was the most frequent isolated organism. Pars plana vitrectomy was performed in 16 eyes as primary treatment, and intravitreal antibiotic injection was done in 27 eyes. Re-treatment with pars plana vitrectomy was required in 15 eyes (34.9%). Best corrected visual acuity (BCVA) at final visit was 20/40 or better in 12 eyes (27.9%), between 20/200 to 20/40 in 17 eyes (39.5%), and worse than 20/200 in 14 eyes (32.6%). Evisceration was done in one eye (2.3%), and retinal detachment happened in 4 eyes (9.3%). Conclusions: The visual outcomes of post cataract surgery endophthalmitis are generally poor. Our results in this study were comparable with many previous studies from other referral centers, however, unlike many reports, streptococcus viridans was the most common isolate in our study.