Postoperative Endophthalmitis: Incidence, Causes and Comparison Between Medical and Surgical Treatment in a United Kingdom Region in the Last 10 Years

Purpose To investigate the incidence, procedures performed, isolated causative microorganisms if found and final visual outcome of Endophthalmitis in a UK tertiary referral centre Methods A retrospective audit of all cases treated as postoperative endopthalmitis in the last 10 years has been performed. Details of each case (preceding ophthalmic procedure, isolated microorganisms, management plan and visual acuity before and after treatment) were recorded Results Sixty patients have been diagnosed with post-operative Endophthalmitis over the audit period. Full data were available for 44 patients. Twenty-four patients (54.54%) had intravitreal injections procedures (IVI) of Anti-VEGF 4 weeks or less before day of presentation, eighteen patients (40.91%) had endophthalmitis following cataract surgery and 2 patients after trabeculectomy (4.55%). Incidence rates were calculated for cataract surgery and IVI in the last 5 years and were 0.024% and 0.048% respectively. All cases received intravitreal injections of antibiotics. Microorganisms were detected in 8 patients. There were 7 culture positive cases with coagulase negative staphylococcus aureus (6 cases after cataract operation, 1 after IVI) and one case with Staphylococcus Legdunens (after IVI). Eighteen patients presented with visual acuity of CF or worse. Eleven of them have been treated with vitrectomy (1st group) while the other seven have not (2nd group). Ten patients from the first group could achieve better visual acuity that that at the time of presentation, while only three patients of the second group showed improvement (p value = 0.04, Fisher Exact test) Conclusions The incidence of endophthalmitis in this audit is comparable to larger studies. Vitrectomy may be recommended for postoperative endophthalmitis patients with visual acuity of CF or worse.