Vitrectomy in the Management of Infectious Endophthalmitis

  • Harry W. FlynnJr.
Conference paper
Part of the FIDIA Research Series book series (FIDIA, volume 2)

Abstract

Infectious endophthalmitis remains a devastating ocular complication, often resulting in complete loss of vision. The use of topical, periocular, and systemic antibiotics is well established in the treatment of endophthalmitis (1–3) and intraocular antibiotics have also been commonly used in recent years (4–6). Vitrectomy has been employed in selected cases, both to obtain a vitreous specimen and to remove infectious material from the vitreous cavity (7–12). The use of vitrectomy instruments in this disease has remained controversial and is not indicated in all cases. This review will summarize the clinical features of endophthalmitis, the decision making process regarding treatment approaches, preparation for and technique of vitreous surgery, culture techniques, recommended antibiotics, and overall visual results in endophthalmitis.

Keywords

Retinal Detachment Intraocular Lens Vitreous Cavity Final Visual Acuity Vitreous Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Allen HF, Mangiaracine AB (1964): Bacterial endophthalmitis after cataract extraction: A study of 22 infections in 20,000 operations. Arch Ophthalmol. 72:454–462.PubMedCrossRefGoogle Scholar
  2. 2.
    Allen HF, Mangiaracine AB (1973): Bacterial endophthalmitis after cataract extraction: II. Incidence in 36,000 consecutive operations with special reference to preoperative topical an-tibiotics. Trans Am Acad Ophthalmol Otolaryngol. 77:581–588.Google Scholar
  3. 3.
    Theodore FH (1965): Bacterial endophthalmitis after cataract surgery. Int Ophthalmol Clin. 5:59.CrossRefGoogle Scholar
  4. 4.
    Forster RK (1974): Endophthalmitis: Diagnostic cultures and visual results. Arch Ophthalmol. 92:387–392.PubMedCrossRefGoogle Scholar
  5. 5.
    Peyman GA, Vastive DW, Crouch ER, Herbst RW (1974): Clinical use of intravitreal an-tibiotics to treat bacterial endophthalmitis. Trans Am Acad Ophthalmol Otolaryngol. 78:862–875.Google Scholar
  6. 6.
    Peyman G A: Antibiotic administration in the treatment of bacterial endophthalmitis (1977): II. Intravitreal injections. Surv Ophthalmol. 21:332–346.Google Scholar
  7. 7.
    Forster RK (1978): Endophthalmitis. In: Duane TD (ed) Clinical Ophthalmology. Hagerstown, MD, Harper and Row, Vol. 4. Ch. 24: 1–20.Google Scholar
  8. 8.
    Cottingham A J, Forster RK (1976): Vitrectomy in endophthalmitis: Results of study using vitrectomy, intraocular antibiotics, or a combination of both. Arch ophthalmol 94:2078–2082.PubMedCrossRefGoogle Scholar
  9. 9.
    Olson JC, Flynn HW, Forster RK, Culbertson WW (1983): Results in the treatment of postoperative endophthalmitis. Ophthalmology 90:692–699.PubMedGoogle Scholar
  10. 10.
    Diamond JG (1981): Intraocular management of endophthalmitis: A systematic approach. Arch Ophthalmol. 99:96–99.PubMedCrossRefGoogle Scholar
  11. 11.
    Puliafito CA, Baker AS, Haaf J, Foster CS (1982): Infectious endophthalmitis: Review of 36 cases. Ophthalmology, 89:921–928.PubMedGoogle Scholar
  12. 12.
    Rowsey J J, Newson DL, Sexton DJ, Harms WK (1982): Endophthalmitis: Current approaches. Ophthalmology 82:1055–1065.Google Scholar
  13. 13.
    Packer AJ, Weingeist TA, Abrams GW (1983): Retinal periphlebitis as an early sign of bacterial endophthalmitis. Am J Ophthalmol. 96:66–71.PubMedGoogle Scholar
  14. 14.
    Doft BH, Clarkson JG, Rebell G, Forster RK (1982): Endogenous Aspergillus endophthalmitis in drug abusers. Arch Ophthalmol. 98:859–862.CrossRefGoogle Scholar
  15. 15.
    Snip RC, Michels RG (1976): Pars plana vitrectomy in the management of endogenous Can-dida endophthalmitis. Am J Ophthalmol. 82:699–704.PubMedGoogle Scholar
  16. 16.
    Charles S (1981): Vitreous Microsurgery. Baltimore, MD, Williams and Wilkins, pp. 155–158, 1981.Google Scholar
  17. 17.
    Gelender H, Flynn HW, Mandelbaum SH (1982): Bacterial endophthalmitis resulting from radial keratotomy. Am J Ophthalmol. 93:323–326.PubMedGoogle Scholar
  18. 18.
    Smith RE, Nozika RA (1983): Uveitis: A Clinical Approach to Diagnosis and Management. Baltimore, MD. Williams and Wilkins, Chapter 209, pp. 94–98.Google Scholar
  19. 19.
    Mandelbaum SM, Forster RK (1983): Infectious endophthalmitis. Clinical modules for ophthalmologists. The American Academy of Ophthalmology, Module 9.Google Scholar
  20. 20.
    Jeglum EL, Rosenberg SB, Benson WE (1981): Preparation of intravitreal drug doses. Ophthalm Surg. 12:355–359.Google Scholar
  21. 21.
    O’Day DM, Jones DB, Patrinely F, Elliott JH (1982): Staphylococcus epidermidis en¬dophthalmitis. Ophthalmology. 89:354–360.PubMedGoogle Scholar
  22. 22.
    D’Amico DJ, Libert J, Kenyon KP, Hanninen LA, Caspers-Velu L (1984): Retinal toxicity of intravitreal gentamicin. Invest Ophthalmol Vis Sci. 25:564–572.PubMedGoogle Scholar
  23. 23.
    Affeldt JC, Forster RK, Mandelbaum SM: Traumatic endophthalmits (in preparation).Google Scholar
  24. 24.
    Brinton GX, Topping TM, Hyndiuk RA, Aaberg TM, Resser FH, Abrams GW (1984): Post-traumatic endophthalmitis. Arch Ophthalmol. 102:547–550.PubMedCrossRefGoogle Scholar
  25. 25.
    Blankenship GW (1977): Endophthalmitis after pars plana vitrectomy. Am J Ophthalmol. 84:815–817.PubMedGoogle Scholar
  26. 26.
    Ho PC, Tolentino FI (1984): Bacterial endophthalmitis after closed vitrectomy. Arch Ophthalmol. 102:207–210.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • Harry W. FlynnJr.
    • 1
  1. 1.The Bascom Palmer Eye Institute, Department of OphthalmologyUniversity of Miami School of MedicineMiamiUSA

Personalised recommendations