Unified Approach to Treating Exogenous Endophthalmitis With Immediate Vitrectomy

To analyze the outcomes and complications of immediate (within 24 hours) small-gauge (23-gauge, 25-gauge) pars plana vitrectomy (PPV) for all causes of exogenous endophthalmitis. A retrospective case series was evaluated. The study included 107 patients who had immediate PPV for exogenous endophthalmitis between 2016 and 2022. The primary outcome measures were the change from baseline best-corrected visual acuity (BCVA) to the final follow-up and the complications after PPV. Causes of exogenous endophthalmitis included intravitreal injections (62.6%), PPV (18.7%), cataract surgery (11.2%), glaucoma surgery (5.6%), and trauma (1.9%). The most common complications were retinal detachment (17.8%) and secondary glaucoma (9.3%). The mean logMAR BCVA improved significantly from the initial diagnosis to the final follow-up (2.26 vs 1.21) ( < .0001). In most cases, immediate small-gauge vitrectomy for exogenous endophthalmitis leads to an improvement in VA, regardless of the VA at presentation. Patients should be counseled about the potential risks associated with PPV surgery.