Surgical wound defects associated with endophthalmitis

Ophthalmic Surg. 1994 Mar;25(3):157-61.

Abstract

Twenty-five consecutive cases of culture-proven postsurgical endophthalmitis were evaluated. Patients underwent wound revision and pars plana vitrectomy with intravitreal antibiotic and steroid infusion (gentamicin 8 micrograms/cc, clindamycin 9 micrograms/cc, dexamethasone 8 micrograms/cc) and injection (gentamicin 100 micrograms plus clindamycin 200 micrograms [and amphotericin 5 micrograms in one case] and dexamethasone 800 to 1000 micrograms). Twenty cases demonstrated wound defects (eg, wound gape/malapposition, abscess/tissue necrosis, suture dehiscence, leak, vitreous wick). Culture-proven isolates included both gram negative and positive bacteria and fungi. Visual acuity improved in 18 of the 20 (90%) gram positive cases. Ten of the 17 (59%) patients in the Staphylococcus epidermidis subgroup achieved a visual acuity of 20/50 or better. Surgical wound defects are frequently associated with culture-proven endophthalmitis. When vitrectomy is included as part of the treatment regimen, we recommend meticulous inspection and closure of any defective surgical wounds associated with endophalmitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cataract Extraction
  • Endophthalmitis / complications*
  • Humans
  • Lenses, Intraocular
  • Postoperative Complications / etiology*
  • Surgical Wound Infection / complications*
  • Visual Acuity
  • Vitrectomy
  • Wound Healing*