Does enucleation in the presence of endophthalmitis increase the risk of postoperative meningitis?
The risk of meningitis after enucleation for endophthalmitis has been cited by several authors as a relative contraindication to this procedure. In order to test this theory, we have conducted a review of 165 enucleation and 54 evisceration specimens with a diagnosis of endophthalmitis received from January 1950 through December 1985. This study showed no cases of post-operative central nervous system (CNS) infection. Most patients for whom endophthalmitis was initially suspected received intensive antibiotic therapy. Although cases of post-enucleation meningitis have been reported in the pre-antibiotic era, the authors conclude that the intensive chemotherapeutic treatment of endophthalmitis today has virtually eliminated the risk of post-enucleation CNS infection.
