Unified Approach to Treating Exogenous Endophthalmitis With Immediate Vitrectomy

Abstract

Purpose: To analyze the outcomes and complications of immediate (within 24 hours) small-gauge (23-gauge, 25-gauge) pars plana vitrectomy (PPV) for all causes of exogenous endophthalmitis. Methods: A retrospective case series was evaluated. Results: The study included 107 patients who had immediate PPV for exogenous endophthalmitis between 2016 and 2022. The primary outcome measures were the change from baseline best-corrected visual acuity (BCVA) to the final follow-up and the complications after PPV. Causes of exogenous endophthalmitis included intravitreal injections (62.6%), PPV (18.7%), cataract surgery (11.2%), glaucoma surgery (5.6%), and trauma (1.9%). The most common complications were retinal detachment (17.8%) and secondary glaucoma (9.3%). The mean logMAR BCVA improved significantly from the initial diagnosis to the final follow-up (2.26 vs 1.21) ( P < .0001). Conclusions: In most cases, immediate small-gauge vitrectomy for exogenous endophthalmitis leads to an improvement in VA, regardless of the VA at presentation. Patients should be counseled about the potential risks associated with PPV surgery.