Endophthalmitis after plana vitrectomy: incidence, microbiology, and visual outcome

The aim of this retrospective study was to analyze incidence, microorganisms, and final visual acuity after pars plana vitrectomy. Data on all patients with endophthalmitis after pars plana vitrectomy performed at Croix-Rousse Hospital, Lyon, France, between 1994 and 2004 were analyzed. Among 1632 posterior vitrectomies done over an 11-year period, 14 cases of endophthalmitis occurred (0.86%). Half of the patients were diabetic with poor glycemic control. The most frequent microorganism was negative coagulase Staphylococcus. One case of Bacillus cereus was noted. On the whole, visual prognosis was poor: final visual acuity never exceeded 20/200 in the best cases. The final visual acuity depended on the initial pathology requiring vitrectomy. One eye was enucleated because of phthisis. Historically, the incidence of endophthalmitis after vitrectomy is approximately 0.05%. It was higher in our series probably because of the high number of diabetic patients with poor glycemic control. Final visual acuity after pars plana vitrectomy in current series is low. Nevertheless it must be compared with the visual acuity before the vitrectomy because it depends greatly on the causal pathology which is very disabling. Endophthalmitis after pars plana vitrectomy is a serious complication. Prophylaxis is still the best treatment.