Improved detection of microorganisms by polymerase chain reaction in delayed endophthalmitis after cataract surgery.

Abstract

To evaluate whether the use of polymerase chain reaction (PCR) improves the identification of the causative pathogen in eyes developing delayed endophthalmitis after cataract surgery. Prospective, noncomparative case series. Consecutive series of 25 eyes with the clinical diagnosis of delayed endophthalmitis after cataract. Presence of bacterial or fungal DNA in aqueous humor and vitreous samples. In the aqueous humor the causative pathogen was identified in 84% (n = 21) of the eyes by PCR compared with 0% by diagnostic culture and 0% by microscopy. In the vitreous samples the pathogen was identified in 92% (n = 23) of the eyes by PCR compared with 24% by diagnostic culture (n = 6) and 0% by microscopy. PCR is useful for the identification of the causative pathogen in delayed endophthalmitis and had a higher rate of positive identification of the causative organism than microscopy or diagnostic culture.