Advertisement

Current Ophthalmology Reports

, Volume 6, Issue 2, pp 105–114 | Cite as

Current Strategies for Prevention and Treatment of Postoperative Endophthalmitis

  • Ashley Brundrett
  • Christopher D. Conrady
  • Akbar Shakoor
  • Amy Lin
Ocular Microbiology and Immunology (B Jeng and L Schocket, Section Editors)
  • 38 Downloads
Part of the following topical collections:
  1. Topical Collection on Ocular Microbiology and Immunology

Abstract

Purpose of review

We review the prevention and treatment of postoperative endophthalmitis.

Recent findings

Postoperative endophthalmitis is rare but has potentially blinding consequences. There is no consensus on prevention, but there are a few controlled studies with methods of decreasing the infection rate, such as use of povidone iodine and intracameral antibiotics. There remains only one randomized controlled study (Endophthalmitis Vitrectomy Study or EVS) on the treatment of postoperative endophthalmitis, but there are retrospective studies which examine the timing and various methods of vitrectomy and intravitreal antibiotics.

Summary

The application of povidone iodine remains a proven method of preventing endophthalmitis, but evidence suggests that intracameral antibiotics further minimize this risk. Further research is needed to define the efficacy of intravitreal antibiotics at the time of cataract surgery. There are many questions regarding treatment, including performance of vitrectomy for eyes with visual acuities better than light perception, smaller vitrectomy port sizes, and intravitreal antibiotics and/or oral steroids.

Keywords

Endophthalmitis Postoperative endophthalmitis Intracameral antibiotics 

Notes

Funding

This work was supported in part by an Unrestricted Grant from Research to Prevent Blindness, Inc., New York, NY, to the Department of Ophthalmology & Visual Sciences, University of Utah. This source of financial support had no role in the study design; the collection, analysis, or interpretation of data; in the writing of the report; or the decision to submit the article for publication.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Friling E, Lundström M, Stenevi U, Montan P. Six-year incidence of endophthalmitis after cataract surgery: Swedish national study. J Cataract Refract Surg. 2013;39(1):15–21.PubMedCrossRefGoogle Scholar
  2. 2.
    Keay L, Gower EW, Cassard SD, Tielsch JM, Schein OD. Postcataract surgery endophthalmitis in the United States: analysis of the complete 2003 to 2004 Medicare database of cataract surgeries. Ophthalmology. 2012;119(5):914–22.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Schmier JK, et al. An updated estimate of costs of endophthalmitis following cataract surgery among Medicare patients: 2010-2014. Clin Ophthalmol. 2016;10:2121–7.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Cullen KA, Hall MJ, Golosinskiy A. Ambulatory surgery in the United States. Natl Health Stat Rep. 2006;2009(11):1–25.Google Scholar
  5. 5.
    Behndig A, Cochener B, Güell JL, Kodjikian L, Mencucci R, Nuijts RMMA, et al. Endophthalmitis prophylaxis in cataract surgery: overview of current practice patterns in 9 European countries. J Cataract Refract Surg. 2013;39(9):1421–31.PubMedCrossRefGoogle Scholar
  6. 6.
    Olson RJ, Braga-Mele R, Chen SH, Miller KM, Pineda R 2nd, Tweeten JP, et al. Cataract in the adult eye preferred practice pattern(R). Ophthalmology. 2017;124(2):P1–p119.PubMedCrossRefGoogle Scholar
  7. 7.
    Chang DF, et al. Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: results of the 2014 ASCRS member survey. J Cataract Refract Surg. 2015;41(6):1300–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Kelkar AS, Chang DF, Kelkar JA, Mehta HM, Lahane T, Parekh R. Antibiotic prophylaxis practice patterns for cataract surgery in India—results from an online survey. Indian J Ophthalmol. 2017;65(12):1470–4.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Grzybowski A, Schwartz SG, Matsuura K, Ong Tone S, Arshinoff S, Ng JQ, et al. Endophthalmitis prophylaxis in cataract surgery: overview of current practice patterns around the world. Curr Pharm Des. 2017;23(4):565–73.PubMedCrossRefGoogle Scholar
  10. 10.
    Meyer JJ, Polkinghorne PJ, McGhee CN. Cataract surgery practices and endophthalmitis prophylaxis by New Zealand ophthalmologists. Clin Exp Ophthalmol. 2016;44(7):643–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Katibeh M, Ziaei H, Mirzaei M, Eskandari A, Moein H, Kalantarion M, et al. Perioperative prophylaxis for endophthalmitis after cataract surgery in Iran. J Ophthalmic Vis Res. 2015;10(1):33–6.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Haripriya A, Baam ZR, Chang DF. Endophthalmitis prophylaxis for cataract surgery. Asia Pac J Ophthalmol (Phila). 2017;6(4):324–9.Google Scholar
  13. 13.
    Ciulla TA, Starr MB, Masket S. Bacterial endophthalmitis prophylaxis for cataract surgery: an evidence-based update. Ophthalmology. 2002;109(1):13–24.PubMedCrossRefGoogle Scholar
  14. 14.
    Nentwich MM, Ta CN, Kreutzer TC, Li B, Schwarzbach F, Yactayo-Miranda YM, et al. Incidence of postoperative endophthalmitis from 1990 to 2009 using povidone-iodine but no intracameral antibiotics at a single academic institution. J Cataract Refract Surg. 2015;41(1):58–66.PubMedCrossRefGoogle Scholar
  15. 15.
    Speaker MG, Menikoff JA. Prophylaxis of endophthalmitis with topical povidone-iodine. Ophthalmology. 1991;98(12):1769–75.PubMedCrossRefGoogle Scholar
  16. 16.
    Ophthalmologists, T.R.C.O. Cataract surgery guidelines. 2010.Google Scholar
  17. 17.
    Nguyen CL, Oh LJ, Wong E, Francis IC. Povidone-iodine 3-minute exposure time is viable in preparation for cataract surgery. Eur J Ophthalmol. 2017;27(5):573–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Shimada H, et al. Reduced anterior chamber contamination by frequent surface irrigation with diluted iodine solutions during cataract surgery. Acta Ophthalmol. 2017;95(5):e373–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Ta CN, Singh K, Egbert PR, de Kaspar HM. Prospective comparative evaluation of povidone-iodine (10% for 5 minutes versus 5% for 1 minute) as prophylaxis for ophthalmic surgery. J Cataract Refract Surg. 2008;34(1):171–2.PubMedCrossRefGoogle Scholar
  20. 20.
    Mino de Kaspar H, et al. Prospective randomized comparison of 2 different methods of 5% povidone-iodine applications for anterior segment intraocular surgery. Arch Ophthalmol. 2005;123(2):161–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Li B, Nentwich MM, Hoffmann LE, Haritoglou C, Kook D, Kampik A, et al. Comparison of the efficacy of povidone-iodine 1.0%, 5.0%, and 10.0% irrigation combined with topical levofloxacin 0.3% as preoperative prophylaxis in cataract surgery. J Cataract Refract Surg. 2013;39(7):994–1001.PubMedCrossRefGoogle Scholar
  22. 22.
    Wu PC, Li M, Chang SJ, Teng MC, Yow SG, Shin SJ, et al. Risk of endophthalmitis after cataract surgery using different protocols for povidone-iodine preoperative disinfection. J Ocul Pharmacol Ther. 2006;22(1):54–61.PubMedCrossRefGoogle Scholar
  23. 23.
    Hosseini H, Ashraf MJ, Saleh M, Nowroozzadeh MH, Nowroozizadeh B, Abtahi MB, et al. Effect of povidone-iodine concentration and exposure time on bacteria isolated from endophthalmitis cases. J Cataract Refract Surg. 2012;38(1):92–6.PubMedCrossRefGoogle Scholar
  24. 24.
    Nentwich MM, Rajab M, Ta CN, He L, Grueterich M, Haritoglou C, et al. Application of 10% povidone iodine reduces conjunctival bacterial contamination rate in patients undergoing cataract surgery. Eur J Ophthalmol. 2012;22(4):541–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Vasavada AR, Gajjar D, Raj SM, Vasavada V, Vasavada V. Comparison of 2 moxifloxacin regimens for preoperative prophylaxis: prospective randomized triple-masked trial. Part 1: aqueous concentration of moxifloxacin. J Cataract Refract Surg. 2008;34(8):1379–82.PubMedCrossRefGoogle Scholar
  26. 26.
    Li B, Miño de Kaspar H, Haritoglou C, Kook D, Kampik A, Sheng M, et al. Comparison of 1-day versus 1-hour application of topical neomycin/polymyxin-B before cataract surgery. J Cataract Refract Surg. 2015;41(4):724–31.PubMedCrossRefGoogle Scholar
  27. 27.
    Ta CN, Sinnar S, He L, Myung D, de Kaspar HM. Prospective randomized comparison of 1-day versus 3-day application of topical levofloxacin in eliminating conjunctival flora. Eur J Ophthalmol. 2007;17(5):689–95.PubMedCrossRefGoogle Scholar
  28. 28.
    Holland EJ, et al. Antibiotic resistance in acute postoperative endophthalmitis. Ophthalmology. 2014;121(11 Suppl):S1–9. quiz S10–2PubMedCrossRefGoogle Scholar
  29. 29.
    Kim SJ, Toma HS. Ophthalmic antibiotics and antimicrobial resistance a randomized, controlled study of patients undergoing intravitreal injections. Ophthalmology. 2011;118(7):1358–63.PubMedGoogle Scholar
  30. 30.
    Kim SJ, Toma HS. Antimicrobial resistance and ophthalmic antibiotics: 1-year results of a longitudinal controlled study of patients undergoing intravitreal injections. Arch Ophthalmol. 2011;129(9):1180–8.PubMedCrossRefGoogle Scholar
  31. 31.
    Dave SB, Toma HS, Kim SJ. Ophthalmic antibiotic use and multidrug-resistant Staphylococcus epidermidis: a controlled, longitudinal study. Ophthalmology. 2011;118(10):2035–40.PubMedCrossRefGoogle Scholar
  32. 32.
    Miyanaga M, Nejima R, Miyai T, Miyata K, Ohashi Y, Inoue Y, et al. Changes in drug susceptibility and the quinolone-resistance determining region of Staphylococcus epidermidis after administration of fluoroquinolones. J Cataract Refract Surg. 2009;35(11):1970–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Milder E, Vander J, Shah C, Garg S. Changes in antibiotic resistance patterns of conjunctival flora due to repeated use of topical antibiotics after intravitreal injection. Ophthalmology. 2012;119(7):1420–4.PubMedCrossRefGoogle Scholar
  34. 34.
    Stringham JD, Relhan N, Miller D, Flynn HW Jr. Trends in fluoroquinolone nonsusceptibility among coagulase-negative Staphylococcus isolates causing Endophthalmitis, 1995-2016. JAMA Ophthalmol. 2017;135(7):814–5.PubMedCrossRefGoogle Scholar
  35. 35.
    Hsu HY, Lind JT, Tseng L, Miller D. Ocular flora and their antibiotic resistance patterns in the midwest: a prospective study of patients undergoing cataract surgery. Am J Ophthalmol. 2013;155(1):36–44.e2.PubMedCrossRefGoogle Scholar
  36. 36.
    Dave SB, Toma HS, Kim SJ. Changes in ocular flora in eyes exposed to ophthalmic antibiotics. Ophthalmology. 2013;120(5):937–41.PubMedCrossRefGoogle Scholar
  37. 37.
    Nejima R, Shimizu K, Ono T, Noguchi Y, Yagi A, Iwasaki T, et al. Effect of the administration period of perioperative topical levofloxacin on normal conjunctival bacterial flora. J Cataract Refract Surg. 2017;43(1):42–8.PubMedCrossRefGoogle Scholar
  38. 38.
    Chung JL, Lim EH, Song SW, Kim BY, Lee JH, Mah FS, et al. Comparative intraocular penetration of 4 fluoroquinolones after topical instillation. Cornea. 2013;32(7):1046–51.PubMedCrossRefGoogle Scholar
  39. 39.
    Gungor SG, Akova YA, Bozkurt A, Yasar U, Babaoglu MO, Cetinkaya A, et al. Aqueous humour penetration of moxifloxocin and gatifloxacin eye drops in different dosing regimens before phacoemulsification surgery. Br J Ophthalmol. 2011;95(9):1272–5.PubMedCrossRefGoogle Scholar
  40. 40.
    Miller JJ, Scott IU, Flynn HW Jr, Smiddy WE, Newton J, Miller D. Acute-onset endophthalmitis after cataract surgery (2000-2004): incidence, clinical settings, and visual acuity outcomes after treatment. Am J Ophthalmol. 2005;139(6):983–7.PubMedCrossRefGoogle Scholar
  41. 41.
    Wallin T, Parker J, Jin Y, Kefalopoulos G, Olson RJ. Cohort study of 27 cases of endophthalmitis at a single institution. J Cataract Refract Surg. 2005;31(4):735–41.PubMedCrossRefGoogle Scholar
  42. 42.
    Lalitha P, Rajagopalan J, Prakash K, Ramasamy K, Prajna NV, Srinivasan M. Postcataract endophthalmitis in South India incidence and outcome. Ophthalmology. 2005;112(11):1884–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Gower EW, et al. Perioperative antibiotics for prevention of acute endophthalmitis after cataract surgery. Cochrane Database Syst Rev. 2017;2:Cd006364.PubMedPubMedCentralGoogle Scholar
  44. 44.
    Barry P, Seal DV, Gettinby G, Lees F, Peterson M, Revie CW, et al. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: preliminary report of principal results from a European multicenter study. J Cataract Refract Surg. 2006;32(3):407–10.PubMedCrossRefGoogle Scholar
  45. 45.
    Herrinton LJ, Shorstein NH, Paschal JF, Liu L, Contreras R, Winthrop KL, et al. Comparative effectiveness of antibiotic prophylaxis in cataract surgery. Ophthalmology. 2016;123(2):287–94.PubMedCrossRefGoogle Scholar
  46. 46.
    Kessel L, Flesner P, Andresen J, Erngaard D, Tendal B, Hjortdal J. Antibiotic prevention of postcataract endophthalmitis: a systematic review and meta-analysis. Acta Ophthalmol. 2015;93(4):303–17.PubMedCrossRefGoogle Scholar
  47. 47.
    Huang J, Wang X, Chen X, Song Q, Liu W, Lu L. Perioperative antibiotics to prevent acute endophthalmitis after ophthalmic surgery: a systematic review and meta-analysis. PLoS One. 2016;11(11):e0166141.PubMedPubMedCentralCrossRefGoogle Scholar
  48. 48.
    ASCRS, ASCRS Clinical Survey 2016. Eyeworld Supplements. 2016.Google Scholar
  49. 49.
    Wong DC, Waxman MD, Herrinton LJ, Shorstein NH. Transient macular edema after intracameral injection of a moderately elevated dose of cefuroxime during phacoemulsification surgery. JAMA Ophthalmol. 2015;133(10):1194–7.PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Cakir B, et al. Toxic anterior segment syndrome after uncomplicated cataract surgery possibly associated with intracamaral use of cefuroxime. Clin Ophthalmol. 2015;9:493–7.PubMedPubMedCentralCrossRefGoogle Scholar
  51. 51.
    Delyfer MN, Rougier MB, Leoni S, Zhang Q, Dalbon F, Colin J, et al. Ocular toxicity after intracameral injection of very high doses of cefuroxime during cataract surgery. J Cataract Refract Surg. 2011;37(2):271–8.PubMedCrossRefGoogle Scholar
  52. 52.
    Lockington D, Flowers H, Young D, Yorston D. Assessing the accuracy of intracameral antibiotic preparation for use in cataract surgery. J Cataract Refract Surg. 2010;36(2):286–9.PubMedCrossRefGoogle Scholar
  53. 53.
    Matsuura K, Suto C, Akura J, Inoue Y. Comparison between intracameral moxifloxacin administration methods by assessing intraocular concentrations and drug kinetics. Graefes Arch Clin Exp Ophthalmol. 2013;251(8):1955–9.PubMedCrossRefGoogle Scholar
  54. 54.
    Montan PG, Wejde G, Setterquist H, Rylander M, Zetterström C. Prophylactic intracameral cefuroxime. Evaluation of safety and kinetics in cataract surgery. J Cataract Refract Surg. 2002;28(6):982–7.PubMedCrossRefGoogle Scholar
  55. 55.
    Murphy CC, Nicholson S, Quah SA, Batterbury M, Neal T, Kaye SB. Pharmacokinetics of vancomycin following intracameral bolus injection in patients undergoing phacoemulsification cataract surgery. Br J Ophthalmol. 2007;91(10):1350–3.PubMedPubMedCentralCrossRefGoogle Scholar
  56. 56.
    Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg. 2007;33(6):978–88.Google Scholar
  57. 57.
    Montan PG, Wejde G, Koranyi G, Rylander M. Prophylactic intracameral cefuroxime. Efficacy in preventing endophthalmitis after cataract surgery. J Cataract Refract Surg. 2002;28(6):977–81.PubMedCrossRefGoogle Scholar
  58. 58.
    Daien V, Papinaud L, Gillies MC, Domerg C, Nagot N, Lacombe S, et al. Effectiveness and safety of an Intracameral injection of cefuroxime for the prevention of endophthalmitis after cataract surgery with or without perioperative capsular rupture. JAMA Ophthalmol. 2016;134(7):810–6.PubMedCrossRefGoogle Scholar
  59. 59.
    Ng AL, et al. Intracameral cefuroxime in the prevention of postoperative endophthalmitis: an experience from Hong Kong. Graefes Arch Clin Exp Ophthalmol. 2016;254(10):1987–92.PubMedCrossRefGoogle Scholar
  60. 60.
    Rodriguez-Caravaca G, et al. Incidence of endophthalmitis and impact of prophylaxis with cefuroxime on cataract surgery. J Cataract Refract Surg. 2013;39(9):1399–403.PubMedCrossRefGoogle Scholar
  61. 61.
    Rock T, et al. Using intracameral cefuroxime reduces postoperative endophthalmitis rate: 5 years experience at the University Eye Hospital Tubingen. Klin Monatsbl Augenheilkd. 2014;231(10):1023–8.PubMedCrossRefGoogle Scholar
  62. 62.
    Jabbarvand M, Hashemian H, Khodaparast M, Jouhari M, Tabatabaei A, Rezaei S. Endophthalmitis occurring after cataract surgery: outcomes of more than 480 000 cataract surgeries, epidemiologic features, and risk factors. Ophthalmology. 2016;123(2):295–301.PubMedCrossRefGoogle Scholar
  63. 63.
    Sharma S, Sahu SK, Dhillon V, Das S, Rath S. Reevaluating intracameral cefuroxime as a prophylaxis against endophthalmitis after cataract surgery in India. J Cataract Refract Surg. 2015;41(2):393–9.PubMedCrossRefGoogle Scholar
  64. 64.
    Matsuura K, Miyoshi T, Suto C, Akura J, Inoue Y. Efficacy and safety of prophylactic intracameral moxifloxacin injection in Japan. J Cataract Refract Surg. 2013;39(11):1702–6.PubMedCrossRefGoogle Scholar
  65. 65.
    Au CP, White AJ, Healey PR. Efficacy and cost-effectiveness of intracameral vancomycin in reducing postoperative endophthalmitis incidence in Australia. Clin Exp Ophthalmol. 2016;44(9):803–11.PubMedCrossRefGoogle Scholar
  66. 66.
    Haripriya A, Chang DF, Namburar S, Smita A, Ravindran RD. Efficacy of Intracameral moxifloxacin endophthalmitis prophylaxis at Aravind Eye Hospital. Ophthalmology. 2016;123(2):302–8.PubMedCrossRefGoogle Scholar
  67. 67.
    Tan CS, Wong HK, Yang FP. Epidemiology of postoperative endophthalmitis in an Asian population: 11-year incidence and effect of intracameral antibiotic agents. J Cataract Refract Surg. 2012;38(3):425–30.PubMedCrossRefGoogle Scholar
  68. 68.
    Garat M, Moser CL, Martín-Baranera M, Alonso-Tarrés C, Álvarez-Rubio L. Prophylactic intracameral cefazolin after cataract surgery: endophthalmitis risk reduction and safety results in a 6-year study. J Cataract Refract Surg. 2009;35(4):637–42.PubMedCrossRefGoogle Scholar
  69. 69.
    Romero-Aroca P, Méndez-Marin I, Salvat-Serra M, Fernández-Ballart J, Almena-Garcia M, Reyes-Torres J. Results at seven years after the use of intracamerular cefazolin as an endophthalmitis prophylaxis in cataract surgery. BMC Ophthalmol. 2012;12:2.PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.
    • Witkin AJ, et al. Vancomycin-associated hemorrhagic occlusive retinal vasculitis: clinical characteristics of 36 eyes. Ophthalmology. 2017;124(5):583–95. This case series identified 36 eyes of 23 patients diagnosed with hemorrhagic occlusive retinal vasculitis (HORV) following routine use of intracameral vancomycin during cataract surgery. These eyes had delayed-onset vision loss with devastating consequences: 61% had final visual acuity of 20/200 or worse. Because of this study, the Americian Society of Cataract and Refractive Surgeons (ASCRS) recommended against the use of intracameral vancomycin during cataract surgery. PubMedCrossRefGoogle Scholar
  71. 71.
    Schwartz SG, Relhan N, O’Brien TP, Flynn HW Jr. A new complication associated with the use of prophylactic Intracameral antibiotics: hemorrhagic occlusive retinal vasculitis. Ophthalmology. 2017;124(5):578–9.PubMedCrossRefGoogle Scholar
  72. 72.
    •• Haripriya A, Chang DF, Ravindran RD. Endophthalmitis reduction with intracameral moxifloxacin prophylaxis: analysis of 600 000 surgeries. Ophthalmology. 2017;124(6):768–75. This retrospective study of over 600,000 patients demonstrated that intracameral moxifloxacin reduced the postoperative endophthalmitis rate by 3.5-fold. Moxifloxacin is of particular interest because it does not have to be compounded by a pharmacy and, thus, precludes dilution errors. PubMedCrossRefGoogle Scholar
  73. 73.
    Libre PE, Mathews S. Endophthalmitis prophylaxis by intracameral antibiotics: in vitro model comparing vancomycin, cefuroxime, and moxifloxacin. J Cataract Refract Surg. 2017;43(6):833–8.PubMedCrossRefGoogle Scholar
  74. 74.
    Lipnitzki I, Bronshtein R, Ben Eliahu S, Marcovich AL, Kleinmann G. Hydrophilic acrylic intraocular lens as a drug delivery system: influence of the presoaking time and comparison to intracameral injection. J Ocul Pharmacol Ther. 2013;29(4):414–8.PubMedCrossRefGoogle Scholar
  75. 75.
    Kashiwabuchi FK, Khan YA, Rodrigues MW, Wang J, McDonnell PJ, Daoud YJ. Seidel and India ink tests assessment of different clear cornea side-port incision configurations. Graefes Arch Clin Exp Ophthalmol. 2013;251(8):1961–5.PubMedCrossRefGoogle Scholar
  76. 76.
    McDonnell PJ, Taban M, Sarayba M, Rao B, Zhang J, Schiffman R, et al. Dynamic morphology of clear corneal cataract incisions. Ophthalmology. 2003;110(12):2342–8.PubMedCrossRefGoogle Scholar
  77. 77.
    Herretes S, Stark WJ, Pirouzmanesh A, Reyes JMG, McDonnell PJ, Behrens A. Inflow of ocular surface fluid into the anterior chamber after phacoemulsification through sutureless corneal cataract wounds. Am J Ophthalmol. 2005;140(4):737–40.PubMedCrossRefGoogle Scholar
  78. 78.
    Wang M, Liu W, Lu QJ, Zeng HY, Liu SM, Yue YK, et al. Pharmacokinetic comparison of ketorolac after intracameral, intravitreal, and suprachoroidal administration in rabbits. Retina. 2012;32(10):2158–64.PubMedCrossRefGoogle Scholar
  79. 79.
    Tyson SL, Bailey R, Roman JS, Zhan T, Hark LA, Haller JA. Clinical outcomes after injection of a compounded pharmaceutical for prophylaxis after cataract surgery: a large-scale review. Curr Opin Ophthalmol. 2017;28(1):73–80.PubMedCrossRefGoogle Scholar
  80. 80.
    Conrady CD, Feistmann JA, Roller AB, Boldt HC, Shakoor A. Hemorrhagic vasculitis and retinopathy heralding as an early sign of bacterial endophthalmitis after intravitreal injection. Retin Cases Brief Rep. 2017:1.Google Scholar
  81. 81.
    Conrady CD, Hanson KE, Mehra S, Carey A, Larochelle M, Shakoor A. The first case of Trypanosoma cruzi-associated retinitis in an immunocompromised host diagnosed by pan-organism PCR. Clin Infect Dis. 2018;(In press).Google Scholar
  82. 82.
    Poulsen EJ, Allingham RR. Characteristics and risk factors of infections after glaucoma filtering surgery. J Glaucoma. 2000;9(6):438–43.PubMedCrossRefGoogle Scholar
  83. 83.
    Sunaric-Megevand G, Pournaras CJ. Current approach to postoperative endophthalmitis. Br J Ophthalmol. 1997;81(11):1006–15.PubMedPubMedCentralCrossRefGoogle Scholar
  84. 84.
    Hanscom TA. Postoperative endophthalmitis. Clin Infect Dis. 2004;38(4):542–6.PubMedCrossRefGoogle Scholar
  85. 85.
    Nishida T, et al. An eleven-year retrospective study of endogenous bacterial endophthalmitis. J Ophthalmol. 2015;2015:261310.PubMedPubMedCentralCrossRefGoogle Scholar
  86. 86.
    Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Endophthalmitis Vitrectomy Study Group. Arch Ophthalmol. 1995;113(12):1479–96.Google Scholar
  87. 87.
    Zhang YQ, Wang WJ. Treatment outcomes after pars plana vitrectomy for endogenous endophthalmitis. Retina. 2005;25(6):746–50.PubMedCrossRefGoogle Scholar
  88. 88.
    Benz MS, Scott IU, Flynn HW Jr, Unonius N, Miller D. Endophthalmitis isolates and antibiotic sensitivities: a 6-year review of culture-proven cases. Am J Ophthalmol. 2004;137(1):38–42.PubMedCrossRefGoogle Scholar
  89. 89.
    Jackson TL, Eykyn SJ, Graham EM, Stanford MR. Endogenous bacterial endophthalmitis: a 17-year prospective series and review of 267 reported cases. Surv Ophthalmol. 2003;48(4):403–23.PubMedCrossRefGoogle Scholar
  90. 90.
    Doft BH, Barza M. Ceftazidime or amikacin: choice of intravitreal antimicrobials in the treatment of postoperative endophthalmitis. Arch Ophthalmol. 1994;112(1):17–8.PubMedCrossRefGoogle Scholar
  91. 91.
    Barza M, Pavan PR, Doft BH, Wisniewski SR, Wilson LA, Han DP, et al. Evaluation of microbiological diagnostic techniques in postoperative endophthalmitis in the Endophthalmitis Vitrectomy Study. Arch Ophthalmol. 1997;115(9):1142–50.PubMedCrossRefGoogle Scholar
  92. 92.
    Haider SA, Hassett P, Bron AJ. Intraocular vancomycin levels after intravitreal injection in post cataract extraction endophthalmitis. Retina. 2001;21(3):210–3.PubMedCrossRefGoogle Scholar
  93. 93.
    Hashemian H, Mirshahi R, Khodaparast M, Jabbarvand M. Post-cataract surgery endophthalmitis: brief literature review. J Curr Ophthalmol. 2016;28(3):101–5.PubMedPubMedCentralCrossRefGoogle Scholar
  94. 94.
    Escariao P, Commodaro AG, Arantes T, CMMB C, MFA D, Brandt CT. Analysis of cytokines in presumed acute infectious endophthalmitis following cataract extraction. J Clin Exp Ophthalmol. 2014;5:335.CrossRefGoogle Scholar
  95. 95.
    • Rayess N, Rahimy E, Storey P, Shah CP, Wolfe JD, Chen E, et al. Post-injection endophthalmitis rates and characteristics following intravitreal bevacizumab, ranibizumab and aflibercept. Am J Ophthalmol. 2016. This large retrospective study helped to define rates and visual outcomes of post-injection endophthalmitis that were similar amongst all anti-VEGF agents with rates between 0.035 and 0.039%.;165:88–93.PubMedCrossRefGoogle Scholar
  96. 96.
    Jackson TL, Paraskevopoulos T, Georgalas I. Systematic review of 342 cases of endogenous bacterial endophthalmitis. Surv Ophthalmol. 2014;59(6):627–35.PubMedCrossRefGoogle Scholar
  97. 97.
    Ravindran RD, Venkatesh R, Chang DF, Sengupta S, Gyatsho J, Talwar B. Incidence of post-cataract endophthalmitis at Aravind Eye Hospital: outcomes of more than 42,000 consecutive cases using standardized sterilization and prophylaxis protocols. J Cataract Refract Surg. 2009;35(4):629–36.PubMedCrossRefGoogle Scholar
  98. 98.
    Moshirfar M, Feiz V, Vitale AT, Wegelin JA, Basavanthappa S, Wolsey DH. Endophthalmitis after uncomplicated cataract surgery with the use of fourth-generation fluoroquinolones: a retrospective observational case series. Ophthalmology. 2007;114(4):686–91.PubMedCrossRefGoogle Scholar
  99. 99.
    Kuhn F, Gini G. Vitrectomy for endophthalmitis. Ophthalmology. 2006;113(4):714.PubMedCrossRefGoogle Scholar
  100. 100.
    Doft BH, Wisniewski SR, Kelsey SF, Fitzgerald SG, Endophthalmitis Vitrectomy Study Group. Diabetes and postoperative endophthalmitis in the endophthalmitis vitrectomy study. Arch Ophthalmol. 2001;119(5):650–6.PubMedCrossRefGoogle Scholar
  101. 101.
    •• Shalaby A, Di Simplicio Cherubini S, Lockwood A, Newsom R. Postoperative endophthalmitis: incidence, causes and comparison between medical and surgical treatment in a United Kingdom region in the last 10 years. Acta Ophthalmol. 2015;93(S255) This paper was a retrospective case review of 60 patients with endophthalmitis from various causes in which the patients with count fingers vision or worse vision that received vitrectomy had significantly better visual outcomes than those that only received intravitreal antibiotics. This raises questions as to whether the presenting visual acuity guidelines should be altered to guide clinicians on when to perform a vitrectomy.Google Scholar
  102. 102.
    DeBry PW, et al. Incidence of late-onset bleb-related complications following trabeculectomy with mitomycin. Arch Ophthalmol. 2002;120(3):297–300.PubMedCrossRefGoogle Scholar
  103. 103.
    Kangas TA, et al. Delayed-onset endophthalmitis associated with conjunctival filtering blebs. Ophthalmology. 1997;104(5):746–52.PubMedCrossRefGoogle Scholar
  104. 104.
    Waheed S, Ritterband DC, Greenfield DS, Liebmann JM, Seedor JA, Ritch R. New patterns of infecting organisms in late bleb-related endophthalmitis: a ten year review. Eye (Lond). 1998;12(Pt 6):910–5.CrossRefGoogle Scholar
  105. 105.
    Ciulla TA, Beck AD, Topping TM, Baker AS. Blebitis, early endophthalmitis, and late endophthalmitis after glaucoma-filtering surgery. Ophthalmology. 1997;104(6):986–95.PubMedCrossRefGoogle Scholar
  106. 106.
    Ohtomo K, et al. Outcomes of late-onset bleb-related endophthalmitis treated with pars plana vitrectomy. J Ophthalmol. 2015;2015:923857.PubMedPubMedCentralCrossRefGoogle Scholar
  107. 107.
    Ba’arah BT, Smiddy WE. Bleb-related endophthalmitis: clinical presentation, isolates, treatment and visual outcome of culture-proven cases. Middle East Afr J Ophthalmol. 2009;16(1):20–4.PubMedCrossRefGoogle Scholar
  108. 108.
    Song A, Scott IU, Flynn MPHHW Jr, Budenz DL. Delayed-onset bleb-associated endophthalmitis: clinical features and visual acuity outcomes. Ophthalmology. 2002;109(5):985–91.PubMedCrossRefGoogle Scholar
  109. 109.
    Busbee BG, et al. Bleb-associated endophthalmitis: clinical characteristics and visual outcomes. Ophthalmology. 2004;111(8):1495–503. discussion 1503PubMedCrossRefGoogle Scholar
  110. 110.
    Meisler DM, Zakov ZN, Bruner WE, Hall GS, McMahon JT, Zachary AA, et al. Endophthalmitis associated with sequestered intraocular Propionibacterium acnes. Am J Ophthalmol. 1987;104(4):428–9.PubMedCrossRefGoogle Scholar
  111. 111.
    Al-Mezaine HS, Al-Assiri A, Al-Rajhi AA. Incidence, clinical features, causative organisms, and visual outcomes of delayed-onset pseudophakic endophthalmitis. Eur J Ophthalmol. 2009;19(5):804–11.PubMedCrossRefGoogle Scholar
  112. 112.
    Aldave AJ, Stein JD, Deramo VA, Shah GK, Fischer DH, Maguire JI. Treatment strategies for postoperative Propionibacterium acnes endophthalmitis. Ophthalmology. 1999;106(12):2395–401.PubMedCrossRefGoogle Scholar
  113. 113.
    Clark WL, Kaiser PK, Flynn HW Jr, Belfort A, Miller D, Meisler DM. Treatment strategies and visual acuity outcomes in chronic postoperative Propionibacterium acnes endophthalmitis. Ophthalmology. 1999;106(9):1665–70.PubMedCrossRefGoogle Scholar
  114. 114.
    Busin M. Antibiotic irrigation of the capsular bag to resolve low-grade endophthalmitis. J Cataract Refract Surg. 1996;22(3):385–9.PubMedCrossRefGoogle Scholar
  115. 115.
    Arsan AK, Sizmaz S, Ozkan SB, Duman S. Corynebacterium minutissimum endophthalmitis: management with antibiotic irrigation of the capsular bag. Int Ophthalmol. 1995;19(5):313–6.PubMedCrossRefGoogle Scholar
  116. 116.
    Lingappan A, et al. Endogenous fungal endophthalmitis: causative organisms, management strategies, and visual acuity outcomes. Am J Ophthalmol. 2012;153(1):162–6 e1.PubMedCrossRefGoogle Scholar
  117. 117.
    Romero CF, Rai MK, Lowder CY, Adal KA. Endogenous endophthalmitis: case report and brief review. Am Fam Physician. 1999;60(2):510–4.PubMedGoogle Scholar
  118. 118.
    Essman TF, Flynn HW Jr, Smiddy WE, Brod RD, Murray TG, Davis JL, et al. Treatment outcomes in a 10-year study of endogenous fungal endophthalmitis. Ophthalmic Surg Lasers. 1997;28(3):185–94.PubMedGoogle Scholar
  119. 119.
    Paulus YM, Cheng S, Karth PA, Leng T. Prospective trial of endogenous fungal endophthalmitis and chorioretinitis rates, clinical course, and outcomes in patients with fungemia. Retina. 2016;36(7):1357–63.PubMedCrossRefGoogle Scholar
  120. 120.
    • Pappas PG, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1–50. This practice guideline helped define appropriate treatment for intraocular candidiasis. PubMedCrossRefGoogle Scholar
  121. 121.
    Bronner S, Jehl F, Peter JD, Ploy MC, Renault C, Arvis P, et al. Moxifloxacin efficacy and vitreous penetration in a rabbit model of Staphylococcus aureus endophthalmitis and effect on gene expression of leucotoxins and virulence regulator factors. Antimicrob Agents Chemother. 2003;47(5):1621–9.PubMedPubMedCentralCrossRefGoogle Scholar
  122. 122.
    Hariprasad SM, Mieler WF, Holz ER. Vitreous and aqueous penetration of orally administered gatifloxacin in humans. Arch Ophthalmol. 2003;121(3):345–50.PubMedCrossRefGoogle Scholar
  123. 123.
    Narang S, Gupta A, Gupta V, Dogra MR, Ram J, Pandav SS, et al. Fungal endophthalmitis following cataract surgery: clinical presentation, microbiological spectrum, and outcome. Am J Ophthalmol. 2001;132(5):609–17.PubMedCrossRefGoogle Scholar
  124. 124.
    Brar GS, Ram J, Kaushik S, Chakraborti A, Dogra MR, Gupta A. Aspergillus niger endophthalmitis after cataract surgery. J Cataract Refract Surg. 2002;28(10):1882–3.PubMedCrossRefGoogle Scholar
  125. 125.
    Lin RC, Sanduja N, Hariprasad SM. Successful treatment of postoperative fungal endophthalmitis using intravitreal and intracameral voriconazole. J Ocul Pharmacol Ther. 2008;24(2):245–8.PubMedCrossRefGoogle Scholar
  126. 126.
    Riddell Jt, Comer GM, Kauffman CA. Treatment of endogenous fungal endophthalmitis: focus on new antifungal agents. Clin Infect Dis. 2011;52(5):648–53.PubMedCrossRefGoogle Scholar
  127. 127.
    Breit SM, Hariprasad SM, Mieler WF, Shah GK, Mills MD, Grand MG. Management of endogenous fungal endophthalmitis with voriconazole and caspofungin. Am J Ophthalmol. 2005;139(1):135–40.PubMedCrossRefGoogle Scholar
  128. 128.
    Aydin S, Ertugrul B, Gultekin B, Uyar G, Kir E. Treatment of two postoperative endophthalmitis cases due to Aspergillus flavus and Scopulariopsis spp. with local and systemic antifungal therapy. BMC Infect Dis. 2007;7:87.PubMedPubMedCentralCrossRefGoogle Scholar
  129. 129.
    Doft BM, Kelsey SF, Wisniewski SR. Retinal detachment in the endophthalmitis vitrectomy study. Arch Ophthalmol. 2000;118(12):1661–5.PubMedCrossRefGoogle Scholar
  130. 130.
    Hariprasad SM, Shah GK, Mieler WF, Feiner L, Blinder KJ, Holekamp NM, et al. Vitreous and aqueous penetration of orally administered moxifloxacin in humans. Arch Ophthalmol. 2006;124(2):178–82.PubMedCrossRefGoogle Scholar
  131. 131.
    Yagci R, et al. Penetration of second-, third-, and fourth-generation topical fluoroquinolone into aqueous and vitreous humour in a rabbit endophthalmitis model. Eye (Lond). 2007;21(7):990–4.CrossRefGoogle Scholar
  132. 132.
    De Kaspar HM, et al. Effects of intravitreal corticosteroid in the treatment of Staphylococcus aureus-induced experimental endophthalmitis. Retina. 2008;28(2):326–32.PubMedCrossRefGoogle Scholar
  133. 133.
    Smith MA, Sorenson JA, D’Aversa G, Mandelbaum S, Udell I, Harrison W. Treatment of experimental methicillin-resistant Staphylococcus epidermidis endophthalmitis with intravitreal vancomycin and intravitreal dexamethasone. J Infect Dis. 1997;175(2):462–6.PubMedCrossRefGoogle Scholar
  134. 134.
    Meredith TA, et al. Intraocular dexamethasone produces a harmful effect on treatment of experimental Staphylococcus aureus endophthalmitis. Trans Am Ophthalmol Soc. 1996;94:241–52. discussion 252–7PubMedPubMedCentralGoogle Scholar
  135. 135.
    Graham RO, Peyman GA. Intravitreal injection of dexamethasone. Treatment of experimentally induced endophthalmitis. Arch Ophthalmol. 1974;92(2):149–54.PubMedCrossRefGoogle Scholar
  136. 136.
    Kim IT, Chung KH, Koo BS. Efficacy of ciprofloxacin and dexamethasone in experimental pseudomonas endophthalmitis. Korean J Ophthalmol. 1996;10(1):8–17.PubMedCrossRefGoogle Scholar
  137. 137.
    Das T, Jalali S, Gothwal VK, Sharma S, Naduvilath TJ. Intravitreal dexamethasone in exogenous bacterial endophthalmitis: results of a prospective randomised study. Br J Ophthalmol. 1999;83(9):1050–5.PubMedPubMedCentralCrossRefGoogle Scholar
  138. 138.
    Gan IM, Ugahary LC, van Dissel JT, Feron E, Peperkamp E, Veckeneer M, et al. Intravitreal dexamethasone as adjuvant in the treatment of postoperative endophthalmitis: a prospective randomized trial. Graefes Arch Clin Exp Ophthalmol. 2005;243(12):1200–5.PubMedCrossRefGoogle Scholar
  139. 139.
    Albrecht E, Richards JC, Pollock T, Cook C, Myers L. Adjunctive use of intravitreal dexamethasone in presumed bacterial endophthalmitis: a randomised trial. Br J Ophthalmol. 2011;95(10):1385–8.PubMedCrossRefGoogle Scholar
  140. 140.
    Jacobs DJ, et al. Intravitreal dexamethasone in the management of delayed-onset bleb-associated endophthalmitis. Int J Inflamm. 2012;2012:503912.CrossRefGoogle Scholar
  141. 141.
    Altan T, Kapran Z, Eser I, Acar N, Ünver YB, Yurttaser S. Comparative outcomes of pars plana vitrectomy in acute postoperative endophthalmitis with 25-gauge and 20-gauge techniques. Jpn J Ophthalmol. 2009;53(5):506–11.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ashley Brundrett
    • 1
  • Christopher D. Conrady
    • 1
  • Akbar Shakoor
    • 1
  • Amy Lin
    • 1
  1. 1.John A. Moran Eye CenterUniversity of UtahSalt Lake CityUSA

Personalised recommendations