Endophthalmitis after ganciclovir implant in patients with AIDS and cytomegalovirus retinitis

PURPOSE: To describe the incidence, clinical course, and outcomes of endophthalmitis in patients treated with a ganciclovir implant. DESIGN: Retrospective review of cases identified from a clinical survey. METHODS. Cases of endophthalmitis were identified from a survey of 30 clinical practices known to treat a large number of patients with cytomegalovirus retinitis. RESULTS: Twenty,four cases of endophthalmitis were identified from 5,185 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. CONCLUSIONS: Endophthalmitis is an infrequent but potentially devastating complication associated with placement of a ganciclovir implant. (C) 2003 by Elsevier Inc. All rights reserved.