Update of the management of postoperative endophthalmitis

JCS Yam, AKH Kwok
Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong

Postoperative endophthalmitis is a rare but potentially devastating complication of intra-ocular surgery. Most cases are caused by bacterial infection. The clinical presentation of endophthalmitis can be classified as acute postoperative endophthalmitis, chronic postoperative endophthalmitis, and bleb-associated endophthalmitis. They each have a different aetiology, treatment, and prognosis. This review discusses these features, as well as the microbiology, diagnosis, and treatment outcomes of these three types of inflammation, with particular emphasis on recent advances in their management. The role of steroids, systemic fluoroquinolones, and the choice of antibiotic against gram-negative bacteria are still controversial and need further study. Moreover, the management of chronic postoperative and bleb-associated endophthalmitis has not been standardised, and no conclusive findings on the efficacy of the various prophylactic measures are available. Thus, the treatment and prevention of postoperative endophthalmitis remain a clinical challenge.

Hong Kong Med J 2004;10:337-43

Key words:Antibacterial agents; Blister; Endophthalmitis; Postoperative complications; Vitrectomy