Managing Post Operative Endophthalmitis Via Anterior Segment Approach

The purpose of the study is to managr the post operative endophthalmitis through a small surgical approach of anterior segment.

We had patients of referral from other hospital settings of endophthalmitis.We managed them through our new approach of treating endophthalmitis.

We included 10 patients with post operative endophthalmitis.All patients had signs of post cataract surgery endophthalmitis and vision with perception of light only.The surgeries of patients were done at some eye surgical camps at countryside some within last week and one had surgery 2 months before.They were managed with aseptic measures of operation room after anterior segment phaco knife incision and washing anterior segment with fortified normal saline with ceftazidime injection 500mg in 1000ml via symco cannula and 0.02ml of 0.5 percent moxifloxacin eye drops were injection with cannula in anterior segment and wound closed with hydration.

9 out of 10 patients had their hypopyon,pain and posterior segment haze resolved within 48 hours of treatment.The one remaining had hypopyon only that was lesser than before and this hypopyon and all other signs of endophthalmitis were resolved after 48 hours more.All patients had post operative antibiotic and steroid dropping started after procedure for every two hours.All patients had recovery of vision from perception of light to 6/60 in 7 patients and 3/60 in other 3 patients.Slit lamp examination and fundus picture was seen in order to exclude any posterior segment involvement yet.B scan was also done to see any hyperechoic areas in vitreous.

The results of this study are very encouraging in managing post operative endophthalmitis through anterior segment approach.The intravitreal injection conventional treatment approach leads to more pain in patients due to increased intraocular pressure as patients had already pain.Also this approach saved patients from vitrectomy as well.In short this anterior chamber wash approach can have beneficial visual and good prognostic results in all patients who underwent this treatment post operatively in time.