PRESENTING AUTHOR : Dr. UMESH BHAMMARKAR, CO –AUTHOR: Dr. DEEPTI MEHTA, INSTITUTE: LIONS CLUB OF HYDERABAD SADHURAM EYE HOSPITAL HYDERABAD

1. POST-CATARACT P. AERUGINOSA
ENDOPHTHALMITIS TREATMENT OUTCOME
STUDY
PRESENTING AUTHOR : Dr. UMESH BHAMMARKAR
CO –AUTHOR: Dr. DEEPTI MEHTA
INSTITUTE: LIONS CLUB OF HYDERABAD
SADHURAM EYE HOSPITAL HYDERABAD

2. • Introduction:
• Post Cataract Endophthalmitis due to
Pseudomonas aeruginosa has been reported
to have poor outcome.
• We present our analysis of treatment results
of managing this condition.

3. • Material and Methods:
• A retrospective analysis of records of 10 eyes of 10
patients with acute post operative endophthalmitis
following cataract surgery with intraocular lens
(IOL) implantation, who were tested culture positive
for Pseudomonas aeruginosa .
• All the patients underwent vitreous tap with
intravitreal injection of Vancomycin 1 mg
Ceftazidime 2.25 mg and Amikacin 0.4mg /0.1 ml
as the first line of treatment.
• Subsequently, Vitrectomy with repeat antibiotic
injection or only repeat antibiotic injection was done
depending upon the clinical response and the
microbiological report.

5. Results:
• 10 eyes of 10 patients were included in the
study. The age ranges from 46-90 years
• The median interval between IOL surgery
and onset of symptoms was7 days (range
1-15days) and the median interval between
onset of symptoms and presentation was 3
days (range from 1-10 days).
• Initial vision was PL only in 06/10 eyes ,
Hand movements (HM) in 2 eyes and 2/60
in 2 eyes.

6. Result.....
• Final visual outcome – no PL in 2/10 eyes
- PL only- 1/10, HM in 2/10 , 3/60 in 3/10 ,
6/60 to 6/18 in 2/10 .2 eyes with vision of
HM or less became phthisical.
• None of the eyes required evisceration. All
the 5 patients with poor outcome (Vision of
no PL, PL and HM) did not undergo
vitrectomy due to corneal involment.

7. Conclusion:
• The outcome of P. aeruginosa
endophthalmitis is poor, but early aggressive
treatment with intravitreal antibiotic and early
vitrectomy has favourable result.
• Corneal involvement precluding vitrectomy
had poor outcome.

8. TAKE HOME MESSAGE
POST-CATARACT P. AERUGINOSA
ENDOPHTHALMITIS SITE THREATENING
COMPLICATIONS
Early aggressive treatment with intravitreal
antibiotic and early vitrectomy has
favourable result .
B-scan is helpful in diagnosis.

9. References
• Han DP, Wisniewski SR, Wilson LA, et al. Spectrum and susceptibilities of
microbiologic isolates in the Endophthalmitis Vitrectomy Study. Am J Ophthalmol. 1996
Jul. 122(1):1-17.
• Johnson MW, Doft BH, Kelsey SF, et al. The Endophthalmitis Vitrectomy Study.
Relationship between clinical presentation and microbiologic spectrum. Ophthalmology.
1997 Feb. 104(2):261-72.
• Lalwani GA, Flynn HW Jr, Scott IU, et al. Acute-onset endophthalmitis after clear
corneal cataract surgery (1996-2005). Clinical features, causative organisms, and
visual acuity outcomes. Ophthalmology. 2008 Mar. 115(3):473-6.
• Lundstrom M, Wejde G, Stenevi U, Thorburn W, Montan P. Endophthalmitis after
cataract surgery: a nationwide prospective study evaluating incidence in relation to
incision type and location. Ophthalmology. 2007 May. 114(5):866-70.
• Ness T, Pelz K, Hansen LL. Endogenous endophthalmitis: microorganisms, disposition
and prognosis. Acta Ophthalmol Scand. 2007 Dec. 85(8):852-6.
• Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the
ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg.
2007 Jun. 33(6):978-88.
• Taban M, Behrens A, Newcomb RL. Acute endophthalmitis following cataract surgery:
a systematic review of the literature. Arch Ophthalmol. 2005 May. 123(5):613-20.

10. References
• Han DP, Wisniewski SR, Wilson LA, et al. Spectrum and susceptibilities of
microbiologic isolates in the Endophthalmitis Vitrectomy Study. Am J Ophthalmol. 1996
Jul. 122(1):1-17.
• Johnson MW, Doft BH, Kelsey SF, et al. The Endophthalmitis Vitrectomy Study.
Relationship between clinical presentation and microbiologic spectrum. Ophthalmology.
1997 Feb. 104(2):261-72.
• Lalwani GA, Flynn HW Jr, Scott IU, et al. Acute-onset endophthalmitis after clear
corneal cataract surgery (1996-2005). Clinical features, causative organisms, and
visual acuity outcomes. Ophthalmology. 2008 Mar. 115(3):473-6.
• Lundstrom M, Wejde G, Stenevi U, Thorburn W, Montan P. Endophthalmitis after
cataract surgery: a nationwide prospective study evaluating incidence in relation to
incision type and location. Ophthalmology. 2007 May. 114(5):866-70.
• Ness T, Pelz K, Hansen LL. Endogenous endophthalmitis: microorganisms, disposition
and prognosis. Acta Ophthalmol Scand. 2007 Dec. 85(8):852-6.
• Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the
ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg.
2007 Jun. 33(6):978-88.
• Taban M, Behrens A, Newcomb RL. Acute endophthalmitis following cataract surgery:
a systematic review of the literature. Arch Ophthalmol. 2005 May. 123(5):613-20.