RESUMO A endoftalmite pós-operatória é uma infecção intraocular grave geralmente associada à cirurgia de catarata. Suas causas mais comuns são bactérias gram-positivas e gram-negativas, bactérias anaeróbias e fungos. Nos últimos anos, os resultados do tratamento das endoftalmites melhoraram mas a sua incidência ainda tem aumentado, apesar da adoção de importantes medidas preventivas pré, intra e pósoperatórias. Geralmente, o diagnóstico é clínico mas a avaliação laboratorial de amostras do humor vítreo é essencial para o isolamento do agente causal e para testes de sensibilidade antibiótica. A injeção intravítrea de antibióticos é a principal forma de tratamento e os corticóides também devem ser usados para ajudar a reduzir a inflamação intraocular. A vitrectomia via pars plana também é utilizada no tratamento da endoftalmite pós-operatória, principalmente se a visão é muito baixa ou se não há boa resposta com a terapia intravítrea inicial. O desenvolvimento futuro de novas formas de diagnóstico e tratamento além da observação rigorosa das medidas profiláticas são fundamentais para melhorar os resultados funcionais e diminuir a incidência desta grave infecção. ABSTRACT Postoperative endophthalmitis is a serious and sight-threatening intraocular infection most frequently associated with cataract surgery. The main causes of the infection are gram-positive and gram-negative bacteria, anaerobic bacteria and fungi. Lately, results of therapy for endophthalmitis have improved but its incidence is still increasing despite the adoption of important pre, intra and postoperative preventive measures. Diagnosis is usually based on clinical findings but laboratory work-up of vitreous specimens is essential for isolation of infecting organisms and antibiotic sensitivity tests. Intravitreal injection of antibiotics is the mainstay of treatment and steroids must also be used to help reducing intraocular inflammation. Pars plana vitrectomy is frequently performed for treatment of postoperative endophthalmitis, especially if vision is severely affected or if there is not a favorable response after initiation of intravitreal therapy. Future development of diagnostic and therapeutic models and rigorous observation of prophylactic standards are critical to optimize functional outcomes and to decrease the incidence of this severe infection.

Purpose: To evaluate the current preferences and trends of the vitreoretinal surgeons in Latin America regarding an open globe injury. Design: Internet based survey. Participants: The Pan-American Retina & Vitreous Society (PRVS), Venezuelan Society of Ophthalmology (VSO), and the Pan-American Collaborative Retina Study Group (PACORES) members participated. Methods: This questionnaire was sent by the principal investigator (JFA) to the PRVS, VSO, and PACORES' web lists with a total of 768 surveys sent. An ocular trauma case scenario was provided with a set of 8 questions related to that case. Results: Out of the 768 surveys sent, 38 (4.95%) physicians from 38 centers of 26 different cities in 13 countries of Latin America responded. The vast majority of consulted specialists do practice at a large city, and consider that severe ocular trauma cases are somewhat/very common in their locations. Most of the respondent surgeon's centers have surgical capability, 63% of them have a room staff available 24/7, most of them operate trauma cases, and 56% perform staged surgery. Half of the consulted specialists are satisfied with how eye trauma logistics are handled in their area. Conclusions: Those who perform the emergency intervention in big city centers have been trained adequately, and the responses were received mostly from trauma centers, with facilities outside regular business hours, allowing a complete approach (suturing plus vitrectomy if needed) of the injured patient. Our results seem to have a response bias as only 1 (2.7%) of the respondents was from a small city, and most of them were from trauma centers. Trauma cases may be referred from small cities to trauma centers in Latin America. Resumen Propósito: Evaluar las preferencias y tendencias actuales de los cirujanos de vítreo y retina en América Latina con respecto a un traumatismo ocular abierto. Diseño: Survey a través de Internet. Participantes: Los miembros de la Sociedad Panamericana de Retina y Vítreo (SPRV), la Sociedad Venezolana de Oftalmología (SVO), y el Grupo de Estudio Panamericano Colaborativo de Retina (PACORES) participaron. Métodos: El cuestionario fue enviado por el investigador principal (JFA) a través de las listas web de la SPRV, SVO y PACORES, con un total de 768 encuestas enviadas. Un escenario de un caso de trauma ocular fue provisto con ocho preguntas referentes a dicho caso. Resultados: De las 768 encuestas enviadas, respondieron 38 (4.95%) médicos de 38 centros de 26 diferentes ciudades en 13 países de Latinoamérica. La vasta mayoría de los especialistas consultados realizan su práctica en grandes ciudades, y consideran que los casos de trauma ocular severo son algo/bastante comunes en sus localidades. La mayoría de los centros de los cirujanos que respondieron cuentan con capacidad quirúrgica, 63% de éstos tienen un personal de emergencia disponible 24/7, la mayoría opera casos de trauma y el 56% realizan cirugía por estadíos. La mitad de los especialistas consultados están satisfechos con cómo la logística de trauma ocular es manejada en su área. Conclusiones: Aquellos que realizan intervenciones de emergencia en los centros de grandes ciudades han sido entrenados adecuadamente, y las respuestas fueron recibidas mayormente de centros de trauma, con servicio fuera de horario de oficina regular, permitiendo un abordaje completo (sutura más vitrectomía de ser necesario) del paciente traumatizado. Nuestros resultados parecen tener un sesgo en las respuestas, ya que sólo 1 (2,7%) de los encuestados que respondieron era de una ciudad pequeña y la mayoría de éstos eran de centros que manejan trauma. Los casos de trauma pudieran ser referidos de las ciudades pequeñas a los centros especializados en trauma en América Latina.