98th Annual Meeting DOG 2000

K 623

Keratitis and endophthalmitis in Mexico

H. E. Ortiz-Bermudez¹, H. Miño de Kaspar², S. J. Fröhlich², L. Espinosa-Bonell¹, V. Klauss², G. Tenorio-Guajardo¹

Introduction: Severe eye infections like keratitis and endophthalmitis still have a poor visual outcome in countries with lower socioeconomic standard like Mexico because of the lack of sufficient microbiologic management and often bad compliance of the patients. This study shows the spectrum of etiologic agents and their susceptibility pattern in keratitis and endophthalmitis as well as the clinical course with its visual outcome after therapy and thus gives material to set better therapeutic regimens in infectious eye diseases in Mexico.

Methods: Between March 1997 and December 1998, a total of 17 cases of endophthalmitis and 36 of keratitis were collected at the Hospital General de México. The visual acuity and the clinical history about time of evolution at first visit, pathogens and their susceptibilities as well as treatment and final evolution were documented. Standard methods established at the University Eye Hospital Munich were used for microbiologic evaluation.

Results: In keratitis, Staph. epidermidis (61%) and Staph. aureus (28%) were the most frequent isolated germs, but also E.coli (6%) and Pseudomonas aeruginosa (6%) occured. History of contact lens wear is not a predisposing factor for keratitis in Mexico and was seen in only 8% of the patients. Ciprofloxacin, imipinem and neomicin were the most effective antibiotics in keratitis, the visual prognosis was a loss of about 2 lines of the Snellen chart with treatment. In endophthalmitis, we found 9 different causing germs, which makes initial treatment more difficult. Susceptibility analysis showed imipinem, ciprofloxacin and amikacin to be the most effective antibiotics in endophthalmitis, the final evolution was enucleation and evisceration in 15 patients.

Discussion: Keratitis and endophthalmitis are frequent causes of loss of vision due to infectious eye diseases in Mexico. The results show clearly that new kinds of therapeutic regimens are needed to get a better prognostic outcome especially in patients with endophthalmitis. None.

¹ Hospital General de México, Dto. de Oftalmología; Mexico City/Mexico
² Dpt. of Ophthalmology, Ludwig-Maximilians-Universität, Munich/Germany