CATARACT SURGERY

Find out the prevalence and visual outcome of acute endophthalmitis after cataract surgery. StudyDesign: Retrospective. Period: 1st January 2001 to 31st December 2009. Setting: Wah Medical College, P.O.F. Hospital Wah Cantt,Rawalpindi. Materials and methods: Fifty cases of acute endophthalmitis who had undergone treatment. Each case of acute endophthalmitiswas evaluated in terms of presentation, detailed examination, treatment and outcome. Microbiological culture of the vitreous aspirates was alsodone to identify the causative organism. The analysis was also meant to identify the prognostic factors of visual outcome of these cases.Results: Fifty patients presented with acute endophthalmitis out of the fifteen thousand cataract surgeries performed during the 9 year period.The incidence of endophthalmitis was 0.33% (95 % CI). A vitreous biopsy with intravitreal injection of antibiotics was done in all the casespresenting with acute endophthalmitis. Decreased visual acuity (90%) and pain (75%) were the main presenting features in these cases.. Therewere 36 (72%) culture positive cases, with staphylococci (50%) being the most common organism found. Vitreous biopsy yielded positiveresults in 36 (72%) patients while negative results with no microbial growth was found in 14(28%) patients. There were 20 (40%) growths ofcoagulase negative staphylococci, 5 (10%) growths of streptococci, 8 (16%) growths of coagulase positive staphylococci, and 3 (6%) of gramnegative organisms. The final visual outcome was recorded after one month. 8 (16%) patients achieved 6/12 or better, 26 (52%) patientsachieved moderately good visual acuity 6/60 to 6/12, while 16 (32%) patients achieved poor visual acuity of less than 6/60. Of the latter groupwho had poor visual acuity, 2 (4%) patients had only perception of light while 1 (2%) patient had no perception of light and 1 (2%) patient hadblind and painful eye who had to undergo evisceration. 6 (16%) patients achieved 6/12 or better visual acuity. Conclusions: The incidence ofendophthalmitis is consistent with other studies. Laboratory diagnosis of the vitreous aspirates helps in the treatment. Achieving a good visualoutcome is possible with treatment of the cases of acute endophthalmitis.