1348hrs: Endophthalmitis (Amir Guerami)
/Abbreviated talk due to running almost 1 hour behind.
Any intraocular surgery can lead to endophthalmitis. Generally pain presenting 1-7 days post-op with AC cells/flare/hypyon. Discusses ESCRS prophylactic Tx to prevent endophthalmitis. Intracameral cefuroxime vs topical treatment no significant difference.
Glaucoma filtration risk thought to be about the same as following cataract surgery (but I don’t think he is including late onset cases that are at lifelong risk.)
Post-traumatic discussed as well with higher risk bacillus infections.
Endogenous endophthalmitis only about 5% of cases. Higher chance fungal with mortality as high as 29%
TASS Toxic Anterior Segment Syndrome usually occurs within the first day following surgery. Basically hyperacute vs typical acute endophthalmitis. Vitiritis rarer in TASS.
Preventive measures include povidone iodine, sterile speculum, pre and post op coverage with little solid evidence for any in particular this topical Tx.
Reviewed all the different treatment regimens depending on nature of organism.
Endophthalmitis Vitrectomy Study also discussed with its finding of vitrectomy if LP or worse vision or chronic endophthalmitis or post trab or endogenous endophthalmitis.
Make correct diagnosis endophthalmitis vs TASS. Tap and Inject vs vitrectomy. Identify organism and use preventive measures.