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G.Ü. Tıp Fak. Göz Hast. Anabilim Dalı Purpose: To assess the results of our medical and surgical treatment approaches in exogenous endophthalmitis.
Methods: Post-traumatic and postoperative endophthalmitis cases treated in Gazi University Ophthalmology Department during 1999-2001 were included in this study. Intravitreal (IV) antibiotic (vancomycin + ceftazidime or amikacin) injection together with either vitrectomy or vitreous biopsy was performed in all cases according to the severity of endophthalmitis. The vitreous samples were placed onto slides for Gram and Giamsa staining and inoculated onto culture medias. Oral ciprofloxacin, topical antibiotic (ofoxacin :.3%+tobramycine 0.3%) and steroid (dexamethasone 0.1%) treatments were administered to the all patients. A second intravitreal antibiotic injection was performed according to the antibiogram results in cases with no response to previous treatment.
Results: Four posttraumatic and 23 postoperative endophthalmitis cases with a mean age of 56.2 ± 25.4 were evaluated. Five (18.5%) of the eyes had positive cultures. All the posttraumatic eyes developed retinal detachment and in spite of performing detachment surgeries with intravitreal silicone oil tamponades, redetachments occurred later. In 9 of the postoperative cases (39.1%), visual acuities increased 2 lines. In 2 eyes (8.7%) inflammation could not be controlled and evisceration was submitted. In the other 12 eyes (52.2%) retinal detachment developed; retinal detachment surgery was performed in 7 eyes and 5 eyes were accepted to be inoperable due to severe proliferative vitreoretinopathy. The mean follow up time was 4.5 ± 3.1 months.
Conclusion: Retinal detachment is one of the most severe complications of endophthalmitis and its treatment. Although inflammation can be controlled with early intravitreal, systemic and topical antibiotic treatments especially in postoperative cases, visual prognosis continues to be poor in spite of new surgical techniques. Keywords : Exogenous endophthalmitis, treatment, complications