The treatment of endophthalmitis after cataract surgery: review of 26 cases.

A retrospective study of 26 cases of postoperative endophthalmitis occurring after extracapsular cataract extraction and lens implantation was conducted between January 1989 and December 1992. Twenty-one of the 26 cases (81%) were diagnosed within two weeks after surgery. The most common organism isolated was Staphylococcus saprophyticus (23%). After the bacterial samples had been taken, cefotaxime or gentamicin was injected into anterior chamber and vitreous space. The therapy regimen consisted of topical tobramycin, Polysporin (polymyxinsulfate, neomycinsulfate and gramicidin), dexamethasone and atropine and parabulbar cefotaxime, netilmicin and betamethasone. Cefotaxime or, alternatively, clindamycin, ciprofloxacin and prednisolone were given systemically. The final visual acuity of 20/40 or more was obtained in 15 cases (58%). Twenty-one patients (81%) achieved a visual acuity of 20/400 or better. Three patients had no light perception after the treatment of endophthalmitis. Silk as suture material in wound closure and rupture of the posterior capsule were found to be risk factors in the development of endophthalmitis. The results of the present study show that effective drug treatment also results in good visual outcome.