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 postoperative 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 preantibiotic era, the authors conclude that the intensive chemotherapeutic treatment of endophthalmitis today has virtually eliminated the risk of post-enucleation CNS infection.