98th Annual Meeting DOG 2000

K 624

Cases of endophthalmitis in the Hannover Area (1992 – 1999)

D. Brockmann, F. Sistani, R. Winter

Introduction: Endophthalmitis is still not completely controlled. The treatment is discussed controversially in literature. 63 cases of postoperative and 11 cases of endogenous endophthalmitis were evaluated retrospectively.

Material and methods: 63 cases of postoperative endophthalmitis and 11 cases of endogenous endophthalmitis were treated in our clinic between 1992 and 1999. History, internal diseases, management, pre- and postoperative visual acuity and results of microbiological examinations were evaluated.

Results: 2/3 of the postoperative cases showed an acute, 1/3 a subacute development. Preceding surgeries were phacoemulsification, ECCE, ICCE with aphacia, vitrectomy, valve implantation and goniotrepanation. There was no accumulation of favourable internal diseases in this collective. Conjunctival smear, anterior chamber material and intravitreal material were examined microbiologically. Intravitreal material allowed the most secure proof of the pathogenic agent. The spectrum contained staphylococcus, enterococcus, streptococcus, corynebact., propionibact., and hemophilus species and differed in the two subgroups. Endogenous endohthalmitis was mostly caused by candida species and had an unfavourable development. Visual outcome depended upon the visual acuity at the time of diagnosis, that was also the base of further management. 2/5 of our cases underwent vitrectomy with intravitreal drug application,1/5 was treated in a conservative manner.

Discussion: Even though there is a decrease in the incidence of endophthalmitis, it remains a serious ophthalmological illness. Management and results of treatment depend upon the visual acuity at the time of diagnosis and the pathogenic potency of the causing agent. In our collective, early vitrectomy and intravitreal drug application seemed to be favourable for the outcome.

Eye Clinic, Hannover Medical School, Carl-Neuberg-Str.1, D-30625 Hannover