THERAPY CONCEPTS IN ENDOGENOUS AND EXOGENOUS ENDOPHTHALMITIS
R. Jalilzadeh, G.W. Nietgen, J. Schmidt
Background: in this retrospective investigation we present our experiences and approaches in treating endogenous and exogenous forms of endophthalmitis. Therapy results are depending on various factors of infection or therapy.
Methods: Between 1995 and 1997 a total of 34 eyes (from 33 patients) were treated because of exogenous endophthalmitis in 29 eyes and because of endogenous endophthalmitis in 5 eyes. A pars-plana vitrectomy with antibiotic rinsing of the internal eye was performed in 23 eyes after conservative therapy with both local and systemic antibiotics and steroids showed no satisfying results.
Results: Patients with exogenous endophthalmitis had a mean post- treatment vision of 0.78. Mean vision of patients who underwent vitrectomy and who regularly showed retinal necrosis with inclusion of the macula was 0.32. Total blindness was seen in 3 of 5 eyes with endogenous endophthalmitis despite pars-plana vitrectomy.
Conclusions: Fast initiation of specific therapy of antibiotic combined with steroids and early pars-plana vitrectomy are beneficial in saving affected eyes. Post treatment vision in these patients is generally satisfying. Prognosis of endogenous endophthalmitis is probably worse due to the generally late onset of therapy in these often septic patients in poor general condition.
Department of Ophthalmology, Philipps University, 35037 Marburg, Germany