Acute endophthalmitis outbreak after cataract surgery

Purpose: To evaluate the source of organisms causing an epidemic of postoperative endophthalmitis and to emphasize the importance of prompt intervention with an early diagnosis. Setting: S.B. Ankara Hospital Eye Department, Ankara, Turkey. Methods: Thirteen patients who had surgery on the same day and developed acute postoperative endophthalmitis were evaluated. Clinical patterns were observed and intraocular cultures and stains performed in 10 eyes. Broad-spectrum intravitreal antibiotics were injected on an empirical basis. Results: Intravitreal cultures showed Pseudomonas aeruginosa in four cases and coagulase-negative staphylococci in three cases; three cases were culture negative. P. aeruginosa were also isolated from irrigation solutions used on the same day. Two patients with P. aeruginosa had a visual acuity of 20/200 and 20/300, respectively. Conclusion: The different culture results were probably related to the amount of inoculation, individual risk factors, and the subconjunctival antibiotic injection given al the end of surgery. That one patient with P. aeruginosa endophthalmitis retained a visual acuity of 20/200 shows the importance of rapid intravitreal antibiotic treatment.