MANAGEMENT OF ENDOPHTHALMITIS FOLLOWING CATARACT SURGERY

To describe the management of endophthalmitis following cataract surgery.

Vitreoretinal Service, Ophthalmology Department, ‘’G. Gennimatas’’ Athens General Hospital

Case presentation, step-by-step high-definition video analysis and discussion of the pertinent literature

A 75-year-old male was referred to our emergency service due to blurred vision and pain in his left eye (LE). His past medical history included coronary heart disease treated with angioplasty and oral anticoagulants. The patient mentioned history of recent complicated cataract surgery, 2 days prior. Visual acuity was 20/20 RE and HM LE. On examination a fibrinous membrane with hypopyon was present in the anterior chamber of his LE. Fundus examination was not possible due to vitreous opacities. B scan ultrasound examination showed involvement of the posterior segment with no signs of retinal detachment.  A vitreous tap and inject was performed immediately with vancomycin, amicacin . Next day the hypopyon was still present, the A/C was flat and there was no improvement of the vitreous opacities. He underwent vitrectomy and intravitreal injection of antibiotics . Intraoperatively, a step-by-step approach was applied, achieving a superb functional and anatomic outcome.

Immediate tap and inject of antibiotics followed by vitrectomy in order to reduce the microbial load, create space for antibiotic action and removal of toxins and vitreous opacities play crucial role  in the management of endophthalmitis preserving good functional vision for the patients