Primary implant placement with evisceration in patients with endophthalmitis

PURPOSE: We report the results of 25 patients with endophthalmitis treated with evisceration with and without cornea preservation and primary orbital implants. DESIGN: Retrospective observational case series. METHODS: The records of 25 consecutive patients who underwent evisceration for endophthalmitis between June 1999 and November 2005 were reviewed. Ages ranged between three and 90 years (mean 57.6 years). The cause of endophthalmitis and bacterial agents were documented. All the patients were treated with topical, intravitreal, and intravenous antibiotics for endophthalmitis before evisceration. RESULTS: The follow-up period was between two months and 79 months (mean 25.4 months). All patients had relief from their pain and were satisfied with their cosmetic appearance and motility. Implant exposure was noted in three (12%) patients and pyogenic granuloma in one (4%) patient, which were treated successfully. Eighteen of the patients had prosthesis fitting at least eight weeks after operation. Seven patients elected to not have prosthesis. CONCLUSION: Unless the endophthalmitis is secondary to severe devastating trauma in which there is no sclera left, primary orbital implant placement with evisceration in these patients is an acceptable treatment.