Journal
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Volume 23, Issue 3, Pages 366-370Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00006982-200306000-00013
Keywords
diabetes mellitus; endophthalmitis; Klebsiella pneumoniae; liver abscess; vitrectomy
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Purpose: To determine the role of pars plana vitrectomy (PPV) in the treatment of Klebsiella pneumoniae endogenous endophthalmitis. Methods: Records of seven consecutive patients (10 eyes) diagnosed with Klebsiella endogenous enclophthalmitis were retrospectively reviewed. Results: Five patients (71%) had diabetes, and four (57%) had a liver abscess as the. sources; In most cases, the inflammation progressed within days and resulted in decreased vision worse than hand motions and a total vitreous abscess, despite systemic and intravitreal antibiotic injections. A PPV with subretinal abscess drainage and silicone oil tamponade was performed within 2 weeks. After 6 months, the retina remained attached in all eyes (100%), and vision was counting fingers or better in five eyes (50%). Two eyes recovered visual acuity between 20/63 and 20/125. Conclusions: Physicians should be alerted to the development of endogenous endophthalmitis in patients with Klebsiella septicemia, especially in diabetics with a hepatobiliary abscess. Aggressive therapy, including early vitrectomy with antibiotic injection, may improve the final outcome in this otherwise devastating ocular condition.
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