A Study on the Outcomes in Post-operative Endophthalmitis

Abstract

Introduction: Post-operative endophthalmitis (POE) is a rare but serious complication of intraocular surgeries, associated with devastating visual outcomes if not promptly diagnosed and treated. This study aimed to evaluate the clinical profile, risk factors, treatment strategies, and outcomes of POE in a tertiary care center. Material and Methods: A prospective observational study was conducted at SRMS Institute of Medical Sciences, Bareilly, from May 2023 to October 2024. Over 43 patients with infectious endophthalmitis following intraocular surgery were included. Data on demographics, prior ocular procedures, systemic comorbidities, microbiology, treatment, and visual outcomes were analyzed using descriptive statistics. Results: The majority of patients were aged 51 to 70 years (76.8%), with a slight male predominance (55.8%). Cataract surgery (37.2%) was the most common preceding procedure, followed by trabeculectomy with cataract surgery (23.3%). Comorbidities included ischemic heart disease (27.9%) and renal disease (25.6%). Fungal growth was detected in 32.6% and bacterial growth in 44.2% of culture samples, with 81.4% showing mixed infections. Ciprofloxacin sensitivity was observed in 55.8% of isolates, while tobramycin showed the highest sensitivity (74.4%). Visual recovery was favorable: 79.1% achieved BCVA of 6/6 at one month, although this declined slightly to 58.1% at six months. Elevated IOP was noted in 62.8% at one week but reduced to 16.3% at six months. Conclusion: Post-operative endophthalmitis remains a vision-threatening complication, most often following cataract or combined intraocular procedures. Early diagnosis, culturebased therapy, and vigilant follow-up are critical in optimizing outcomes. Despite initial severe impairment, most patients achieved significant visual improvement, underscoring the importance of prompt and tailored management.