Al Shifa Endophthalmitis Study: Protocol of treatment and prognosis.
Al-Shifa J Ophthalmol Jan ;1(2):88-94.
Purpose of Study: To assess the success rate of Al Shifa treatment protocol for post-operative endophthalmitis Study design: Retrospective analysis of treated cases Methodology: All the patients presenting with post-operative endophthalmitis were given the standard treatment after obtaining intracameral and intravitreal samples. The treatment given was intravitreal vancomycin 1.0 mg with 0.05cc of kenacort, intracameral vancomycin 0.45mg in .04cc along with 25 mg sub-conjunctival vancomycin. Topical half hourly antibiotics employed postoperatively were tobramycin, dexamethasone combination with ciprofloxacin round the clock for first 36 hrs. Patients also received postoperative topical cycloplegics. The main study outcomes were visual acuity and media clarity. The total follow up was 8-12 weeks. Results: 57 patients with postoperative endophthalmitis were included in the study. All the patients presented with severe visual disability ranging from perception of Hand Movements to perception of light only. There was no retinal view of any kind in 77%, while in the rest only red reflex was visible. By the final study follow-up, 53% patients achieved visual acuity of 6/18 or better, 14% achieved 6/30 or better, 26% patients had final visual acuities up to hand movements and only four [7%] patients were with no light perception at the final study follow-up visit. In 73% of patients, media cleared to show the retinal view. Conclusion: With modern management, endophthalmitis is no more the ravaging disease it was in the past. Many patients who develop endophthalmitis will maintain reading vision in the involved eye. Therefore the rapid initiation of appropriate treatment may result in excellent visual results. Al Shifa Journal of Ophthalmology 2005; 1(2): 88-94 © Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan.
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