Evaluating Exaggerated, Prolonged, or Delayed Postoperative Intraocular Inflammation - 19/08/11

Doi : 10.1016/j.ajo.2010.04.012

Rishi R. Doshi ^a, J. Fernando Arevalo ^b, Harry W. Flynn ^c, Emmett T. Cunningham ^a,^d,^⁎
^a Department of Ophthalmology, California Pacific Medical Center, San Francisco, California
^b Retina and Vitreous Service, Clínica Oftalmológica Centro Caracas, Caracas, Venezuela
^c The Bascom Palmer Eye Institute, University of Miami, Miami, Florida
^d Department of Ophthalmology, Stanford University School of Medicine, Stanford, California

Inquiries to Emmett T. Cunningham, Jr., West Coast Retina Medical Group, 185 Berry Street, Lobby 2, Suite 130, San Francisco, CA 94107

Résumé

Purpose

To provide a diagnostic approach for the evaluation of patients with exaggerated, prolonged, or delayed postoperative intraocular inflammation.

Design

Perspective.

Methods

Selected articles on normal and abnormal postoperative intraocular inflammation were reviewed and interpreted in the context of the authors' clinical and research experience.

Results

In addition to infectious endophthalmitis, a number of noninfectious conditions characterized by exaggerated, prolonged, or delayed postoperative inflammation have been described. Heuristically, increased postsurgical inflammation may be categorized by time from surgery to first recognition using the following general guidelines: as immediate and occurring within 2 days after surgery; as early and occurring after 2 days, but within the first 2 weeks, after surgery; and as delayed and occurring more than 2 weeks after surgery.

Conclusions

Although infectious endophthalmitis always must be excluded as a cause of increased postoperative intraocular inflammation, potential noninfectious causes also exist. We review both infectious and noninfectious causes of increased postoperative inflammation and provide a diagnostic framework for evaluating such patients.

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