INTRODUCTION: ENDOPHTHALMITIS is a severe complication of penetrating ocular trauma. POSTTRAUMATIC ENDOPHTHALMITIS is a condition in which an infective organism gains access to the eye at the time of injury. The aim of this study was to identify some of the factors associated with increased incidence of POSTTRAUMATIC ENDOPHTHALMITIS.METHODS: sectional analysis was performed on 458 consecutive patients with penetrating ocular trauma presenting to Feiz Hospital. Some clinical variables were evaluated for association with an increased risk of ENDOPHTHALMITIS.RESULTS: ENDOPHTHALMITIS occurred in 45 (9.8%) of 458 patients. There was a statistical association between ENDOPHTHALMITIS and a rural setting, corneoscleral wounds, hyphema, and delayed primary repair.DISCUSSION: Patients living in villages, those undergoing surgery with delay, and patients with corneoscleral laceration and hyphema stood an increased risk of POSTTRAUMATIC ENDOPHTHALMITIS. Identification of ENDOPHTHALMITIS risk factors would heighten suspicion for infection in certain eyes.

Purpose: To investigate etiological factors of ENDOPHTHALMITIS in Farabi Eye Hospital. Methods: In a retrospective study, the clinical records of 223 patients admitted to the hospital with final diagnosis of ENDOPHTHALMITIS between March 2002 and March 2004 were reviewed. Analyzed factors included: age, sex, clinical presentation, clinical course, microbiological data, treatment modality, visual outcome, and surgical complications.Results: Two hundred twenty three patients with final diagnosis of ENDOPHTHALMITIS were evaluated. One hundred and fifty patients (67%) were male and 73 (33%) were female. 50.2% of the patients were older than 40 years, 14.3% fall in the range of 17-40 years and 30.5% in the range of 2-16 years, and 4.9% were younger than 2 years of age. 57% of ENDOPHTHALMITIS cases were postoperative, 40.5% were POSTTRAUMATIC, and 2.5% were endogenous. Overall 15.9% of the cases had positive culture. Wound leakage was noted in 39% and vitreous loss in 22% of postoperative patients. During 3.5-6.5 months (mean 4.5 months) visual acuity was 20/400 or better in 69.5% of POSTTRAUMATIC cases and in 44.5% of postoperative patients. Finally 92.8% of patients required at least one vitrectomy procedure as a part of their management. Evisceration or enucleation was performed in 8.1% as a primary operation or in the course of their treatment.Conclusion: The incidence of postoperative ENDOPHTHALMITIS in this study is similar to other studies.POSTTRAUMATIC ENDOPHTHALMITIS incidence is less than the mean incidence of other reports. The rate of positive culture was also less than other studies.

Purpose: To evaluate the efficacy of intraocular Gentamicin and Clindamycin in prevention of acute POSTTRAUMATIC bacterial endophthlamitis following penetrating ocular injuries.Desigin: Randomized Clinical Trial (Double-masked) Methods: 177 eyes of 177 patients with penetrating ocular injuries were enrolled. Following primary repair, the eyes were randomized in two groups; eyes in the antibiotic injection group were given intracameral or intravitreal injection of 0.1 mL antibiotic (40µg Gentamicin and 45 µg Clindamycin). Eyes in the control group were given no intraocular injections. All patients received standard prophylactic antibiotic therapy (systemic, subconjunctival, and topical). Results: The overall incidence of ENDOPHTHALMITIS was 2.3% (4 of 177 eyes). All ENDOPHTHALMITIS cases occurred in the control group (P=0.029). The incidence of ENDOPHTHALMITIS was higher in those who had intraocular foreign bodies (P<0.001), in those with posterior lens capsule rupture (P=0.002), and in eyes with vitreous penetration (P=0.02). Conclusion: Intraocular injection of Gentamicin and Clindamycin seems to be an effective procedure in prevention of acute POSTTRAUMATIC ENDOPHTHALMITIS.

Purpose: To evaluate the etiology and risk factors of post-PK ENDOPHTHALMITIS.Materials and method: Published articles from 1976 to 2000 were reviewed from literature and internet web sites.Results: Reported post-op ENDOPHTHALMITIS is between 1 to 7%. Of 8883 donor corneas sent by the I.R.I. Eye Bank, ENDOPHTHALMITIS has been reported in 8 cases (1%).Conclusion: Despite all preventive measures, post PK ENDOPHTHALMITIS is a night-mare for all corneal surgeons.

Introduction: Although POSTTRAUMATIC ENDOPHTHALMITIS is an uncommon condition, it causes severe complications, so medical and pharmacological interventions for prevention of ENDOPHTHALMITIS after trauma are a major concern. The aim of this study was to evaluate the efficacy and clinical outcome of oral ciprofloxacin versus intravenous cefazolin/gentamicin for the prevention of ENDOPHTHALMITIS after penetrating ocular trauma. Materials and Methods: This was a retrospective, descriptive single‑ center study, including all cases of penetrating ocular trauma seen in the Feiz Hospital, a Tertiary Referral Eye Hospital in Isfahan, Iran, between 2011 and 2017. Data systemically recorded for each patient included clinical, ophthalmological, and demographic findings by a trained medical record abstractor or ophthalmologist reviewing patient records. Results: Six hundred and forty‑ five patients in cefazolin/gentamicin and 273 patients in oral ciprofloxacin groups were included in the study. Our study showed that the incidence of ENDOPHTHALMITIS was not significantly different between the two groups (P = 0. 463). In patients with either sharp or blunt penetrating ocular trauma. Conclusion: Oral ciprofloxacin as a prophylactic treatment could prevent POSTTRAUMATIC ENDOPHTHALMITIS as effective as injectable cefazolin/gentamicin. Due to easier consumption of oral ciprofloxacin and lower systemic complications, in all patients with penetrating eye trauma, oral administration of ciprofloxacin is preferable to intravenous or intramuscular types of antibiotics to reduce the risk of POSTTRAUMATIC ENDOPHTHALMITIS.

Purpose: To review the current methods in the diagnosis and management of patients suffering from different forms of ENDOPHTHALMITIS.Method: By literature search up to 2001, a relevant list of articles was retrieved. All articles were reviewed, summarized and used for preparation of this manuscript Results and Conclusion: Except the ENDOPHTHALMITIS Vitrectomy Study (EVS) which is a randomized clinical trial, the published literature contains information from case series, which lack a control group and randomization. Follow up is limited and visual outcome varies widely and is highly dependent on the type of ENDOPHTHALMITIS and emergent referral of patients for proper management of intraocular infection. Considering the poor visual outcome of all forms of ENDOPHTHALMITIS, prophylaxis should have a greater role. Prognosis of these unfortunate events depends on immediate diagnosis, differentiation of acute from chronic form, and early establishment of proper medical and surgical treatment. Sampling intraocular fluids for microbiological study usually provides reliable results. Prognosis in culture negative cases, late onset ENDOPHTHALMITIS, and infection with low virulence organisms is better than infection with streptococci, gram negative organisms, and bacillus cereus.

Purpose: A case report of a patient with endogenous ENDOPHTHALMITIS following acute cholecystitis. Case Report: a 64-year-old woman without medical history underwent uncomplicated cataract surgery due to a mature cataract and was discharged with essential recommendations. A few hours later, she was admitted to the hospital because of acute abdominal pain, and with the diagnosis of acute cholecystitis, cholecystectomy was done and intravenous antibiotic therapy was started. On a postop day, 1 frequent prophylactic topical antibiotic and steroid was started but 3 days later, the patient’ s eye was visited at the clinic with the signs of fulminant acute ENDOPHTHALMITIS and total corneal melting. Intravenous, intravitreal, and topical antibiotic therapies started for the patient after admission as endogenous ENDOPHTHALMITIS, but unfortunately, the infection was unresponsive to treatment and the eye was lost. A week later, evisceration was done for the patient. Conclusion: Endogenous ENDOPHTHALMITIS is an uncommon type of ENDOPHTHALMITIS and the early diagnosis and treatment are important for the patient both visually and vitally.

Purpose: To evaluate cases of post-traumatic ENDOPHTHALMITIS in terms of risk factors.Method: This chart review was performed on 67 eyes of 67 patients who were admitted to Shiraz Khalili Hospital with a clinical impression of post-traumatic ENDOPHTHALMITIS following penetrating eye trauma from 2002 to 2004 serving as the case group. Sixty-five patients with penetrating eye trauma but not ENDOPHTHALMITIS were selected as controls. Results: The case group included 52 (78%) male and 15 (22%) female subjects with mean age of 26.0±9.3 years, of which 33 (49%) were rural residents. The control group included 47 (72%) male and 18 (28%) female subjects with mean age of 24.0±11.2 years, of which 14 (21.5%) were from rural areas. Delayed repair (later than 24 hours) was seen in 44 (66%) of cases and 7 (11%) of controls (P=0.0005). Intraocular foreign body was found in 9 cases (13%) and 10 controls (15%) (P=0.46). Lens rupture was found in 38 cases (57%) and 3 controls (5%) (P=0.0005). The cornea was only involved in 30 cases (45%) and 45 controls (69%). Scleral involvement was seen in 37 cases (55%) vs 20 controls (31%) (P=0.012).Conclusion: Lens rupture, delayed primary repair and rural area as well as limbal and sclera involvement were associated with a higher rate of ENDOPHTHALMITIS. However, intraocular foreign body, age and sex had no role in predisposing to ENDOPHTHALMITIS.

Purpose: To report a case of endogenous Klebsiella ENDOPHTHALMITIS associated with liver abscess in Iran.Case report: A 79 year old man was referred with chief complaint of left eye pain and visual loss. The patient had conjunctival hyperemia, corneal edema, hypopyon and severe vitreous cellular reaction in the left eye and yellowish conjunctival discoloration which was apparent in the right eye. Abdominal CT scan revealed a right liver lobe abscess that underwent percutaneous liver biopsy under sonography guide. Blood, vitreous and liver mass cultures revealed Klebsiella Pneumonia growth. The patient was diagnosed as a case of endogenous Klebsiella ENDOPHTHALMITIS secondary to bacteremia associated with liver abscess.Conclusion: This report suggests that rather than being confined to Far East, endogenous ENDOPHTHALMITIS secondary to liver abscess due to Klebsiella pneumonia may be a global problem.

Purpose: To report three cases of Burkholderia cepacia ENDOPHTHALMITIS following uneventful phacoemulsification surgery. Case Report: Three cases presented with blurriness of vision 2 to 3 weeks following phacoemulsification. Vitreous culture confirmed the diagnosis. Pars plana vitrectomy with intravitreal injection of vancomycin (1 mg/0. 1 ml) and ceftazidime (2. 25 mg/0. 1 ml) was performed. Despite several modalities of treatment, 2 cases did not respond to intravitreal antibiotics and vitrectomy. The first case ended up with phthisis bulbi and the second case underwent evisceration. One case improved after intravitreal injection of the first dose of antibiotic. Conclusion: B. cepacia ENDOPHTHALMITIS is rare and difficult to treat. More studies are necessary to understand the course and outcome of the infection.