June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Postoperative bacterial endophthalmitis: tap/inject versus sutureless vitrectomy
Author Affiliations & Notes
  • Thomas Lindquist
    Ophthalmology, University of Alabama-Birmingham, Birmingham, AL
  • Lauren Mason
    Retina Consultants of Alabama, Birmingham, AL
  • John Mason
    Retina Consultants of Alabama, Birmingham, AL
  • John Mason
    Retina Consultants of Alabama, Birmingham, AL
  • Gerald McGwin
    Ophthalmology, University of Alabama-Birmingham, Birmingham, AL
  • Carrie Huisingh
    University of Alabama- Birmingham, Birmingham, AL
  • Duncan Friedman
    Retina Consultants of Alabama, Birmingham, AL
  • Robert Morris
    Retina Specialists of Alabama, Birmingham, AL
  • Matthew Oltmanns
    Retina Specialists of Alabama, Birmingham, AL
  • Amanda Dinsmore
    School of Medicine, University of Alabama-Birmingham, Birmingham, AL
  • Footnotes
    Commercial Relationships Thomas Lindquist, None; Lauren Mason, None; John Mason, None; John Mason, None; Gerald McGwin, None; Carrie Huisingh, None; Duncan Friedman, None; Robert Morris, None; Matthew Oltmanns, None; Amanda Dinsmore, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3173. doi:
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      Thomas Lindquist, Lauren Mason, John Mason, John Mason, Gerald McGwin, Carrie Huisingh, Duncan Friedman, Robert Morris, Matthew Oltmanns, Amanda Dinsmore; Postoperative bacterial endophthalmitis: tap/inject versus sutureless vitrectomy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3173.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To compare sutureless vitrectomy (VIT) versus vitreous tap with injection (TAP) in eyes presenting with postoperative bacterial endophthalmitis.

Methods: Retrospective cohort study of 126 consecutive eyes with postoperative bacterial endophthalmitis that underwent initial VIT (n=82) or TAP (n=44) between 2005 and 2011 at the UAB Callahan Eye Foundation Hospital. All eyes were stratified into a group according to their pre and postoperative visual acuity (group 1= 20/40 or better, group 2= 20/50-20/100, group 3 = <20/100-20/400, group 4 = <20/400-CF, group 5 = HM-LP) for statistical analysis. Outcome measures were post-intervention vision and complications.

Results: Mean preoperative vision was 20/2000 in VIT group and 20/1800 in TAP (p=0.30). Mean postoperative vision was 20/160 in VIT and 20/125 in TAP (p=0.18). Cultures were positive in 75/126 (60%) eyes, and 8 organisms were identified. The most common organisms were coagulase-negative Staphylococcus 46/126 (37%), Streptococcus sp. 14/126 (11%), and Enterococcus sp. 6/126 (4.7%). Preoperative vision was HM or LP in 87/126 eyes. Among those with poor preoperative vision of <20/400, postoperative vision was significantly better in the VIT group when compared to the TAP group (p=0.05). In eyes with good preoperative vision (20/400 or better), the mean postoperative vision was not significantly different between the VIT or TAP group (p=0.94). Final vision in all eyes was 20/40 or better in 25%. In 56%, vision was 20/100 or better; only 11% had vision of HM or worse. Risk factors for poor outcome (<20/400) included infection with Enterococcus (p=0.01). Preoperative vision and IOP (<5 or >26) showed a trend toward poor outcome (p=0.09 and 0.08 respectively). Twelve eyes (9.5%) developed retinal detachment (RD), all in the VIT group, with 11/12 presenting with poor preoperative vision.

Conclusions: In the largest series to date since the Endophthalmitis Vitrectomy Study, VIT or TAP appears to have similar visual outcome in patients with postoperative bacterial endophthalmitis that present with 20/400 or better vision. Sutureless vitrectomy was found to be more beneficial than TAP in patients with worse than 20/400 initial vision. The majority of patients have a final vision of 20/100 or better. RD is more likely in the VIT group primarily due to poor presenting visual acuity.

Keywords: 513 endophthalmitis  
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