Vitrectomy for endophthalmitis after intraocular lens implantation

Purpose: To report the results of vitrectomy and intraocular lens (IOL) removal for the treatment of endophthalmitis after IOL implantation. Methods: We reviewed 14 eyes of 14 patients who underwent pars plana vitrectomy because of postoperative endophthalmitis. Culture results, surgical methods, and visual outcome are presented. Results: The cultures grew Enterococcus faecalis (n = 3), Staphylococcus epidermidis (n = 2), Propionibacterium acnes (n = 1), and gram-negative bacillus (n = 3). The eyes infected with E. faecalis had poor visual outcome. Eleven eyes treated by the combination of pars plana vitrectomy and IOL removal did not have a recurrence. The remaining 3 eyes on which only vitrectomy was performed had a recurrence, and the additional procedures consisting of vitrectomy and IOL removal could result in eradicating endophthalmitis. Conclusions: A higher rate of E. faecalis was detected and these eyes had severe inflammation and poor visual outcome. Combined vitrectomy and IOL removal may be a more certain method to prevent recurrence. (C) 2000 Japanese Ophthalmological Society.