Long-term outcomes and factors associated with visual recovery after small-gauge vitrectomy for infectious endophthalmitis: a 10-year experience at a single tertiary center in Taiwan.

PURPOSE: To evaluate long-term visual outcomes and prognostic factors after small-gauge pars plana vitrectomy (PPV) for exogenous endophthalmitis.

METHODS

Single-center, retrospective cohort of 45 eyes (45 patients) undergoing PPV for exogenous endophthalmitis (June 2014-September 2024). Demographics, etiology, microbiology, surgical parameters, and outcomes were reviewed. Best-corrected visual acuity (BCVA) was recorded preoperatively and at final follow-up. Associations with final BCVA were explored using univariate tests.

RESULTS

Median BCVA improved from hand motion (~ 20/4000; logMAR 2.30) to approximately 20/1200 (logMAR 1.78; p = 0.004). Overall, 51.1% improved and 24.4% achieved ≥ 20/40. Factors associated with worse final BCVA included poorer initial BCVA (p = 0.002), culture positivity (p = 0.037), and intraoperative retinal detachment (p = 0.009). Favorable factors were 27-gauge PPV (p = 0.044) and post-cataract etiology (p = 0.006).

CONCLUSION

Small-gauge PPV, including 27-gauge, was associated with meaningful visual improvement in exogenous endophthalmitis. Final visual outcomes appeared to be influenced by baseline vision, microbial virulence, and the presence of retinal detachment. However, given the highly heterogeneous nature of this cohort, these findings should be interpreted with caution and may warrant further validation. Our findings provide contemporary data complementing the Endophthalmitis Vitrectomy Study and reflect outcomes achievable with modern techniques.