Acute-onset endophthalmitis following pars plana vitrectomy for symptomatic vitreous opacities: a case series
Abstract
Background: Pars plana vitrectomy (PPV) for symptomatic vitreous opacities, commonly referred to as floaterectomy, is an increasingly performed elective procedure that can meaningfully improve quality of life. However, like all intraocular surgery, it carries the risk of endophthalmitis. To our knowledge, only 2 cases of this complication following floaterectomy have previously been reported. The purpose of this study is to report the largest series of acute-onset bacterial endophthalmitis following floaterectomy, characterizing clinical presentation, causative organisms, antibiotic susceptibilities, histopathology, and visual outcomes.
Methods: This was a retrospective, interventional case series conducted at a tertiary referral center. A query of all patients who underwent PPV for vitreous opacities from January 2010 through December 2025 was performed. Patients were included if they developed acute-onset endophthalmitis (within one month of PPV).
Results: Five eyes of 5 patients were included. Two of 394 patients (0.5%) who underwent floaterectomy at our institution developed acute-onset endophthalmitis; 3 additional cases were referred from outside retina specialists. Mean presenting BCVA was 2.1 logMAR (~ 20/2500). Four of 5 vitreous cultures (80%) were positive: 2 gram-positive (Staphylococcus caprae, Staphylococcus lugdunensis) and 2 gram-negative (Pseudomonas aeruginosa, Serratia marcescens). The institutional endophthalmitis rate of 0.5% was not statistically…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 394 participants or records.
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