ABSTRACT
Objectives: To assess the incidence and visual outcome of acute post operative endophthalmitis treated by intravitreal antibiotics. Methods: This Prospective study was conducted at Department of Ophthalmology, Liaquat University Eye Hospital Hyderabad from November 2002 to October 2010. One hundred and nine patients of acute post operative endophthalmitis were treated with intravitreal antibiotics. The inclusion criteria of the patients was the clinical diagnosis of acute post operative endophthalmitis within 14 days of post operative period and visual acuity better than or equal to hand movement close to face. After enrolment, vitreous tap was carried out followed by intravitreal antibiotics injection. The outcome was measured in terms of clinical resolution of endophthalmitis and post resolution best corrected visual acuity. Results: Of the 109 patients 97 meet the criteria and followed completely were included. Sixty patients [61.9%] had extracapsular cataract extraction [ECCE] with posterior chamber intraocular lens implantation while phacoemulsification done in 37 [38.1%] patients. The visual acuity at presentation was 6/60 or worse in 80 [82.5%] patients. Vitreous tap was done in 86 [88.7%] patients. Vitreous biopsy yields an organism in 32 [33%] patients. Coagulase positive were the most common organism. 75 [77.3%] patients received single dose of intravitreal antibiotic. Forty five [46.4%] patients received single antibiotic, ceftazidime while two antibiotics given in 52 [53.6%] patients. Twenty five [25.8%] patients also had oral steroids. Ninety one [93.8%] patients responded to intravitreal antibiotics. Seventy five [77.32%] patients achieved final visual outcome better than 6/60 in meantime of 54.08 days. Six [6.2%] patients developed no perception of light and another six patients [6.2%] referred for vitrectomy. Conclusion: The final visual outcome of the patients with acute postoperative endophthalmitis is strongly associated with the visual acuity at presentation as well as type of infective organisms
ABSTRACT
To identify the different microbial pathogens in infective corneal ulcers. Observational study. Department of Ophthalmology Unit I, Eye Hospital, Liaquat University of Medical and Health Sciences, Hyderabad, Sindh, from April 2006 to September 2008. Patients above 15 years of age with suspected infective corneal ulcers were studied. After detailed history every patient underwent a comprehensive ophthalmic slit lamp bio-microscopical examination, for characteristics of the ulcer to locate the site, size, depth of ulcer and anterior chamber inflammation. After a detailed ocular examination corneal scrapings were collected under aseptic conditions under magnification of slit lamp or operating microscope. The scraping material obtained from leading edge and base of each ulcer was spread onto labeled slides for staining. Another portion was inoculated on to the surface of solid and the liquid culture medias. The inoculated medias were incubated at appropriate temperature for appropriate time. Of the 328 patients; 192 [64.99%] were male with age ranging from 15 to 80 years, and majority from rural population [64.99%]. Majority i.e. 201 [61.28%] were previously treated. Out of 328 patients, 161 cultured [49.10%] for bacteria, 87 [26.52%] for fungi, and 12 were found positive culture for both bacteria and fungi. The rest of 68 [20.73%] were culture-negative corneal ulcers. Of the 173 bacterial isolates, 119 [68.79%] had Gram positive cocci, most common isolated being Staphylococcus aureus in 82 [47.40%]; fungal pathogens were isolated from 99 corneal ulcers. The commonest organism isolated was Candida albicans in 75.76%, followed by Aspergillus flavus in 11.11% of the total fungal isolates. Staphylococcus aureus, Candida albicans and Aspergillus flavus were common causes of microbial infective keratitis in this series