Clinical characteristics and surgical outcomes of endogenous Klebsiella pneumoniae endophthalmitis.

Purpose: To evaluate surgical outcomes and prognostic factors related to visual acuity (VA) in endogenous Klebsiella pneumoniae endophthalmitis (EKE).

Materials and methods: This retrospective study included patients diagnosed with EKE who underwent pars plana vitrectomy (PPV). Patients were divided into two groups based on the best-corrected VA (BCVA). Eyes with BCVA worse than counting fingers (CF) were classified as having poor vision, while those with BCVA of CF or better were classified as having good vision. Prognostic factors for poor outcomes were identified using least absolute shrinkage and selection operator (LASSO) and logistic regression.

Results: Overall, 64 eyes from 56 patients with EKE were included, of which 51 eyes (43 patients) underwent PPV. At final follow-up, BCVA had improved among patients with PPV. In this subgroup, the mean logarithm of the minimum angle of resolution (logMAR) VA improved from 2.269 ± 0.570 to 2.092 ± 0.713. The VA preservation rate was 86.667%. LASSO and logistic regression showed that three predictors of poor outcomes: poor initial VA, presence of corneal edema, and delayed PPV.

Conclusions: Early PPV is associated with improved VA outcomes in EKE. Poor initial VA, corneal edema, and delayed surgery were significantly associated with worse visual prognosis.