Eyes removed for primary ulcerative keratitis with endophthalmitis: microbial and histologic findings.

OBJECTIVES

To study the microbiological and histological findings in patients whose eyes are removed for primary ulcerative keratitis with suppurative endophthalmitis.

METHODS

Survey of consecutive cases of ulcerative keratitis with histologically defined endophthalmitis treated by enucleation or evisceration.

RESULTS

Eighteen cases of ulcerative keratitis with suppurative endophthalmitis were identified. Thirteen corneal ulcers were culture positive (72%). Microorganism were found in histologic sections of the anterior segment of 9 eyes (50%), but no microorganisms were identified in the vitreous. Two eyes (11%) had culture-positive endophthalmitis. Half of the patients in this study who had undergone elective intraocular surgery had done so within 4 months of enucleation.

CONCLUSIONS

Considerable vitreous inflammation can occur with microbial keratitis in the absence of histologically demonstrable microorganisms in the vitreous. Microbial keratitis associated with suppurative endophthalmitis is usually caused by virulent organisms. The factors that contributed to the spread of purulent inflammation inside the eye could not be assessed in this morphologic study because of the lack of clinical data.