Pars plana vitrectomy results of exogenous endophthalmitis in children

PURPOSE. To identify the etiology, culture results, pars plana vitrectomy results, complications, and visual outcome of exogenous endophthalmitis in children. METHODS. Seven eyes of 7 consecutive pediatric patients who were treated and followed up for exogenous endophthalmitis between February 2006 and June 2008 were included in this study. The etiology of endophthalmos was penetrating eye injuries in 4 eyes and intraocular surgery in 3 eyes. Combined pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection were performed on all 7 eyes. Anterior chamber fluid and vitreous cultures were taken from all eyes. The patient files were inspected retrospectively. RESULTS. Mean follow-up time was 10.3 months (4-16 months). Mean age of the patients was 8.5 years (3-14 years). At baseline, visual acuity values of the patients were light perception (n = 2), hand movements (n = 4), and counting fingers from 1 meter (n = 1). At final examination, visual acuity improved in 5 eyes, stayed the same in 1 eye, and decreased in 1 eye. Positive culture results were obtained in 3 eyes: alpha hemolytic Streptococcus (n = 2) and coagulase-negative Staphylococcus (n = 1). Complications seen after vitreoretinal surgery were transient ocular hypertension, emulsification of silicone oil, phthisis bulbi, and secondary retinal detachment. CONCLUSIONS. Early pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection improved anatomic and functional success in pediatric eyes with exogenous endophthalmitis. (Eur J Ophthalmol 2010; 20: 424-8)