Does Endophthalmitis Following Strabismus Surgery Require Scleral Perforation?

In reply

We thank Dr Bloom for his thoughtful comments on our article.¹

Salamon and associates² describe one case of endophthalmitis that developed after scleral perforation. They presumed that a similar perforation occurred in the second case, although surgeon observation and pathologic examination failed to produce evidence to support this hypothesis beyond reasonable doubt. Kushner and Meyers³ describe a case of endogenous endophthalmitis unassociated with perforation. Rosenbaum⁴ references Reinecke's communication about endophthalmitis that developed secondary to a suture abscess in the absence of scleral perforation. We believe that these cases do not support the conclusion that all cases of endophthalmitis following strabismus surgery result from scleral perforation. We maintain that the development of endophthalmitis following strabismus surgery neither requires nor implies that perforation has occurred.