Abstract

The signs and symptoms of infection after retinal detachment surgery may be subtle and frequently are overlooked during early stages. A retrospective analysis of 3,334 consecutive procedures for retinal detachment revealed 37 cases (1.1%) with postoperative infection. In 13 of these a scleral abscess and a form of endophthalmitis developed, whereas 24 had no evidence of vitreous involvement and were classified as the granuloma type. Only 43% of infected patients had positive cultures. Analysis of changes in infection rate involved comparison with changes over the years in suture material, implant material, performance of scleral undermining, drainage of subretinal fluid, number of previous surgical procedures, age of patient, use of diathermy or cryotherapy, and type of prophylactic antibiotic therapy. During the 13 years studied the rate of infection decreased from 2.2% to 0.7%. Treatment requires surgical removal of all foreign material before the inflammatory signs can be cleared. Concurrent appropriate antibiotic therapy also is recommended. With this form of treatment, all but one patient showed a satisfactory response, although four patients still have mild conjunctival congestion.