Positive culture results and longer duration between onset and microincision vitrectomy have adverse effects on post-cataract surgery endophthalmitis outcome

Abstract

Purpose: To evaluate the efficacy of microincision vitrectomy surgery (MIVS) for the treatment of post-cataract surgery endophthalmitis, and to report the factors which influence the outcome. Methods: This retrospective case series included eyes with post-cataract surgery endophthalmitis that had received MIVS between June 2014 and May 2017. The anatomical and functional results were analyzed. Results: 24 eyes of 24 patients were included with mean age 72.0 ± 8.6 years old. Best-corrected visual acuity (BCVA) improved in 70.8% of patients with a significant mean logMAR BCVA change of −0.6 ± 0.9. Positive culture rate was 25%. In all study eyes, inflammation became silent after MIVS. In univariate analysis, patients with improved BCVA have shorter duration between cataract surgery and MIVS and less likely to have positive culture results. Using degree of BCVA improvement as a continuous variable, it showed that duration between cataract surgery and MIVS had significantly negative correlation with BCVA improvement. Patients with positive culture results had significantly lower BCVA improvement. Multiple regression models also confirmed the most important outcome-influencing factors. Conclusion: MIVS is an efficient management for post-cataract surgery endophthalmitis. BCVA is significantly improved after MIVS. No matter in univariate or multivariate analysis, positive culture results and longer duration between cataract surgery and MIVS have significant negative effects on the outcome of post-cataract surgery endophthalmitis. Multicenter collaboration should be conducted in order to formulate better management protocols of this vision-threatening complication of cataract surgery. Keywords: Cataract surgery, Microincision vitrectomy surgery, Exogenous endophthalmitis, Wide-angle viewing systems