Features and outcomes of eyes that underwent surgical repair of rhegmatogenous retinal detachments after being treated for acute endophthalmitis.
Abstract
PURPOSE: To evaluate the etiology, clinical course, and outcomes of eyes that suffered post-endophthalmitis rhegmatogenous retinal detachments (RRD).
METHODS: A retrospective, consecutive case series was conducted of patients managed at Associated Retinal Consultants P.C. from January 2013 to December 2019. Patients were identified as having had endophthalmitis by ICD-9/10 codes. Those with endophthalmitis and/or RRD not managed at ARC were excluded.
RESULTS: Charts of 413 patients were reviewed and 19 met inclusion criteria. Incidence of RRD following infectious endophthalmitis was 4.6%. The most common inciting events for endophthalmitis was intravitreal injection (9 of 19) and cataract surgery (7 of 19). Fifteen of 19 patients were treated with an injection of intravitreal antibiotics and 4 underwent immediate vitrectomy with antibiotic injection. Biopsy cultures were obtained in 18 of 19 patients and yielded positive growth in 12 (66.7%). Seventeen of the 19 eyes were operable. Final retinal reattachment rate was 88.2% (15 of 17). Mean final logMAR visual acuity (VA) was 1.58 (Snellen 20/765). Factors associated with worse final VA after surgical repair included preceding intravitreal injection (p=0.001), streptococcus species (p=0.024), presence of proliferative vitreoretinopathy (p=0.015), and use of silicone oil during primary RRD repair (p=0.010).
CONCLUSIONS: Rhegmatogenous retinal detachments following endophthalmitis occur infrequently. Though the majority of eyes can be repaired surgically, visual outcomes are often poor, particularly in eyes that were infected with streptococcal species and had associated PVR.