Endophthalmitis after ganciclovir implant in patients with AIDS and cytomegalovirus retinitis.

Abstract

To describe the incidence, clinical course, and outcomes of endophthalmitis in patients treated with a ganciclovir implant. Retrospective review of cases identified from a clinical survey. Cases of endophthalmitis were identified from a survey of 30 clinical practices known to treat a large number of patients with cytomegalovirus retinitis. Twenty-four cases of endophthalmitis were identified from 5185 implants performed (incidence, 0.46%). Final visual acuity ranged from 20/20 to no light perception, with 50% (12/24) seeing light perception or worse. Vitreous cultures revealed Staphylococcus epidermidis in 29% (7/24) of patients, whereas other gram-positive organisms were responsible in 42% (10/24) of cases. In the remaining 29% (7/24) of cases, no organisms were cultured; these cases exhibited a better visual outcome (P =.007). Six of the eight late-onset cases were associated with wound problems such as implant strut or suture exposure. There was no significant relationship between implant removal and final visual acuity. Endophthalmitis is an infrequent but potentially devastating complication associated with placement of a ganciclovir implant.