ABSTRACT
BACKGROUND: Postoperative endophthalmitis is a public health issue due to its bad prognosis; its treatment is both surgical and medical. Classically, surgical treatment was done if visual acuity is limited to light perception only. AIM: To evaluate therapeutic results Of postoperative endophtalmitieS and to Compare therapeutics almost used intravitreal injection of antibiotics versus early vitrectomy. METHODS: It's a retrospective comparative study includIng 120 cases of acute postoperative endophthalmitis hospitalized in a referral ophthalmology department between July 2007 and June 2013. A comparison was conducted between two groups of 24 and 94 patients; the first-line treatment was early vitrectomy for the first group and intravitreal antibiotic injection alone for the second group. RESULTS: The overall incidence rate was 0.38 %, Streptococcus and Staphylococcus Epidermidis where the most common bacterial strain (16 patients each). The treatment outcome was very favorable for 11 patients with final visual acuity higher or equal to 2/10, the outcome was intermediate for 43 patients and poor for 66 patients because of final visual acuity lower than or equal to 1/20, loss of media transparency or anatomical or functional loss of the eye. The prognostic factors statistically correlated to treatment outcome where intense initial inflammation (p<0.001), high bacterial virulence (p=0.002), bacteria culture positive to Streptococcus (p=0.024), a defectuous operative incision (p= 0.012), age over 80 (p=0.022) and posterior capsule rupture (p=0.013). Early vitrectomy group (group1) achieved a higher percentage of good outcome (60% vs 41.5%, p=0.098 ). CONCLUSION: Functional result is better in the Vitrectomy group than in the antibiotic intravitreal injections group whereas not Statically signifiant.
