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Abstract
Abstract
On the Choice of the Pars-plana Vitrectomy in the Treatment of Endogenous Endophthalmitis
Schrader W. F., Dancker K., Marquardt D.
Universitäts-Augenklinik, Würzburg
Purpose: Endogenous mycotic endophthalmitis as the underlying cause for a prolonged posterior uveitis is still underestimated. Due to delayed diagnosis the functional aoutcome may be impaired. We analyzed retrospectively the role of pars plana vitrectomy in the successful treatment of these cases.
Method: 38 eyes were treated for endogenous endophthalmitis between 1987 and 2003. These cases were retrospectively analyzed for the etiology, microbial results, antibiogram, treatment and functional out-come. Important sequences of the surgical procedure are shown in detail.
Results: 5 of 38 eyes with endogenous infection were caused by bacteria, 33 by candida albicans. The patients only regained reading ability, when a pars plana vitrectomy was performed within 4 weeks after onset of symptoms or after known sepsis. When vitrectomy was performed later or when a systemic therapy was performed alone, functional results were less favourable.
Conclusions: Adequate timing of vitrectomy is of major influence on the functional outcome, even if the course of the endogenous endophthalmits is prolonged as compared to most cases of postoperative endophthalmitis.