Improved detection of microorganisms by polymerase chain reaction in delayed endophthalmitis after cataract surgery

Objective: To evaluate whether the use of polymerase chain reaction (PCR) improves the identification of the causative pathogen in eyes developing delayed endophthalmitis after cataract surgery. Design: Prospective, noncomparative case series. Participants: Consecutive series of 25 eyes with the clinical diagnosis of delayed endophthalmitis after cataract. Main Outcome Measure: Presence of bacterial or fungal DNA in aqueous humor and vitreous samples. Results: In the aqueous humor the causative pathogen was identified in 84% (n = 21) of the eyes by PCR compared with 0% by diagnostic culture and 0% by microscopy. In the vitreous samples the pathogen was identified in 92% (n = 23) of the eyes by PCR compared with 24% by, diagnostic culture (n = 6) and 0% by microscopy. Conclusions: PCR is useful for the identification of the causative pathogen in delayed endophthalmitis and had a higher rate of positive identification of the causative organism than microscopy or diagnostic culture. (C) 2000 by the American Academy of Ophthalmology.