Features of treatment of acute postoperative endophthalmitis

Frolychev I.A.; Pozdeyeva N.A.

doi:https://doi.org/10.17116/oftalma202514102159

Frolychev I.A.

Cheboksary branch of S.N. Fedorov National Medical Research Center “MNTK “Eye microsurgery”;
Institute of Advanced Medical Training

ORCID: 0000-0002-2876-1755

Pozdeyeva N.A.

Cheboksary branch of S.N. Fedorov National Medical Research Center “MNTK “Eye microsurgery”;
Institute of Advanced Medical Training

ORCID: 0000-0003-3637-3645

Features of treatment of acute postoperative endophthalmitis

Authors:

Frolychev I.A., Pozdeyeva N.A.

More about the authors

Journal: Russian Annals of Ophthalmology. 2025;141(2): 59‑66

DOI: 10.17116/oftalma202514102159

Read: 926 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Frolychev IA, Pozdeyeva NA. Features of treatment of acute postoperative endophthalmitis. Russian Annals of Ophthalmology. 2025;141(2):59‑66. (In Russ.)
https://doi.org/10.17116/oftalma202514102159

Подписка 2026 Вестник офтальмологии (Russian Annals of Ophthalmology)

Использование инфографики авторами научных работ

Close metadata

PURPOSE

The purpose of this study was to analyze the outcomes of treatment of acute postoperative endophthalmitis and verify its main causative agents.

MATERIAL AND METHODS

The study included 49 patients (49 eyes) with acute postoperative endophthalmitis that developed following surgical interventions in various clinics. At the onset of endophthalmitis, 3 patients (6.1%) retained object vision with visual acuity ranging from 0.05 to 0.20, while 7 patients (14.3%) had visual acuity between 0.01 and 0.05. Visual acuity deteriorated to finger counting near face in 15 patients (30.6%), to 1/∞ pr.l.certa in 21 patients (42.9%), and to 1/∞ pr.l.incerta in 3 patients (6.1%).

All patients were treated using a new technique we developed, which involved short-term tamponade of the vitreous cavity with perfluorodecalin and intravitreal administration of antibiotics. Before treatment start, biological material was collected for bacteriological examination.

RESULTS

Visual function was preserved in 46 patients (93.9%). Clinically significant improvement in visual acuity (0.3—0.4) was observed in 36 patients (73.5%), while 6 patients (12.2%) achieved visual acuity greater than 0.5. No cases of recurrent inflammation were recorded; however, laser tyndallometry indicated a persistent disruption of the blood-ocular barrier for up to 6 months post-treatment, with a protein flow value of 14.6 (8.4; 19.2) ph/ms (p=0.002).

The most informative method for identifying the etiological cause of endophthalmitis was vitreous sampling (81.6% effectiveness), compared to anterior chamber sampling (38.8% effectiveness).

CONCLUSION

The best functional outcomes were achieved in patients with endophthalmitis caused by S. epidermidis and S. aureus. Endophthalmitis caused by gram-negative bacteria had a poor visual prognosis.

Keywords:

endophthalmitis

vitrectomy

perfluorodecalin

intraocular sampling

bacteriological examination

Authors:

Frolychev I.A.

Cheboksary branch of S.N. Fedorov National Medical Research Center “MNTK “Eye microsurgery”;
Institute of Advanced Medical Training

ORCID: 0000-0002-2876-1755

Pozdeyeva N.A.

Cheboksary branch of S.N. Fedorov National Medical Research Center “MNTK “Eye microsurgery”;
Institute of Advanced Medical Training

ORCID: 0000-0003-3637-3645

Received:

27.10.2024

Accepted:

14.01.2025

Close metadata

References:

Simakurthy S, Tripathy K. Endophthalmitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. Accessed 10.12.2023. https://pubmed.ncbi.nlm.nih.gov/32644505
Kuhn F, Grzybowski A. When is vitrectomy for endophthalmitis needed? Acta Ophthalmol. 2023;101(1):8. https://doi.org/10.1111/aos.15245
Relhan N, Forster RK, Flynn HW. Endophthalmitis: Then and Now. Am J Ophthalmol. 2018;187:xx-xxvii. https://doi.org/10.1016/j.ajo.2017.11.021
Astakhov SYu, Vokhmyakov AV. Endophthalmitis: prophylaxis, diagnostics and management (review of the literature). Ophthalmology reports= Oftal’mologicheskie vedomosti. 2008;1(1):35-45 (In Russ.).
Mahabadi N, Gurnani B, Czyz CN. Bacterial Endophthalmitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. Accessed 12.10.2023. https://www.ncbi.nlm.nih.gov/books/NBK545184
Van Swol JM, Myers WK, Beall JA, Atteya MM, Blice JP. Post-traumatic endophthalmitis prophylaxis: a systematic review and meta-analysis. J Ophthalmic Inflamm Infect. 2022;12(1):39. https://doi.org/10.1186/s12348-022-00317-y
Kazajkin VN, Ponomarev VO, Takhchidi HP. Modern aspects of the treatment of acute bacterial postoperative endophthalmitis. Ophthalmology in Russia. 2017;14(1):12-17 (In Russ.) https://doi.org/10.18008/1816-5095-2017-1-12-17
Nikolaenko VP, Belov DF. Antibiotic prophylaxis of acute postoperative endophthalmitis. Russian journal of clinical ophthalmology=Klinicheskaya oftal’mologiya. 2021;21(4):220-226 (In Russ.). https://doi.org/10.32364/2311-7729-2021-21-4-220-226
Barry P, Cordovés L, Gardner S. ESCRS Guidelines for Prevention and Treatment of Endophthalmitis following Cataract Surgery: Data, Dilemmas and Conclusions. Paper Presented at the European Society of Cataract and Refractive Surgeons. Dublin, Ireland: 2013. Accessed 10.10.2024. https://www.escrs.org/media/uljgvpn1/english_2018_updated.pdf
Samudio M, Abente S, Fariña N, López Y, Duré C, Laspina F, Guillén R, Salinas CLÁ, Castillo V, Palacios J, Santacruz I, Nentwich M. Analysis of antibiotic resistance and genetic profile of conjunctival bacteria flora before and after cataract surgery. Int Ophthalmol. 2023;43(2):519-530. https://doi.org/10.1007/s10792-022-02450-y
Tan CL, Sheorey H, Allen PJ, Dawkins RCH. Endophthalmitis: Microbiology and Organism Identification Using Current and Emerging Techniques. Ocul Immunol Inflamm. 2023;31(2):393-401. https://doi.org/10.1080/09273948.2022.2027468
Vinogradskaya OI, Lipatov DV, Fadeyev VV. Safety of different types of methylprednisolone puls-therapy in the treatment of Graves’ orbitopathy. Clinical and experimental thyroidology=Klinicheskaya i eksperimental’naya tireoidologiya. 2012;8(3):52-58 (In Russ.).
Frolychev I.A. Eksperimental’noe obosnovanie etapnogo lecheniya posleoperatsionnykh endoftal’mitov s primeneniem perftororganicheskogo soedineniya s rastvorami antibakterial’nykh preparatov: dis. … kand. med. nauk. Moscow: 2019 (In Russ.). https://www.mntk.ru/files/upload/dissertasia-Frolychev.pdf
Instruktsiya po primeneniyu meditsinskogo izdeliya: material dlya vitreoretinal’nykh operatsii. Pfokalin® po TU 32.50.13-001-18007853-2017. Accepted 21.10.2024 (In Russ.). https://docs.nevacert.ru/files/med_reestr_v2/57603_instruction.pdf
Endophthalmitis Vitrectomy Study Group. Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Arch Ophthalmol. 1995;113:1479-1496.
Kazaikin VN, Ponomarev VO. Analysis of the treatment of acute bacterial postoperative endophthalmitis. Sovremennye tekhnologii v oftal’mologii. 2015;(1):72-75 (In Russ.).
Frolychev IA, Pozdeyeva NA, Nikolaev IA, Kolbovskaya LV. Ways of treatment of staphylococcus postoperative endophthalmitis (experimental investigation). Oftal’mokhirurgiya. 2018;1:66-71 (In Russ.). https://doi.org/10.25276/0235-4160-2018-1-66-71
Frolychev IA, Pozdeyeva NA. Perfluorodecalin with antibiotic solutions in the treatment of postoperative endophthalmitis. In: New technologies in ophthalmology 2021: materials of the Republican scientific and practical conference. Eds Khusainova DK, Abdulaeva EA. Kazan’: 2021. P. 140-143 (In Russ.). https://www.elibrary.ru/item.asp?id=46437588&pff=1
Asbell PA, Sanfilippo CM, Mah FS. Antibiotic susceptibility of bacterial pathogens isolated from the aqueous and vitreous humour in the Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) Surveillance Study: 2009-2020 update. J Glob Antimicrob Resist. 2022;29:236-240. https://doi.org/10.1016/j.jgar.2022.03.010