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Lisa M. Athwal, Rana J. Mady, Albert S. Khouri, Bart Holland, Robert Fechtner, Paul J. Lama, Marco A. Zarbin, Neelakshi Bhagat; A Retrospective Review of Endophthalmitis Following Glaucoma Surgery: A Look at Treatment Selection and Long Term Visual Acuity Outcome. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5591.
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© ARVO (1962-2015); The Authors (2016-present)
To compare two treatments, (1) Pars plana vitrectomy (PPV) with intravitreal antibiotics (IVitAb) vs. (2) IVitAb alone, for endophthalmitis following glaucoma surgery.
Retrospective review of 24 eyes (21 trabeculectomy and 3 shunt drainage device) that presented with glaucoma surgery related endophthalmitis to University Hospital in Newark, NJ between April 2001 and November 2008. Patients were divided into two groups based on initial
Mean initial and final VA in the PPV+IVitAb and IVitAb groups was poor (2.34,1.96 and 1.8,1.9 respectively). In groups 1 and 2 respectively, mean height of hypopyon at presentation was 1.25mm and 0.92mm and mean vitritis severity score was 2.25 and 1.82. The severity vitritis score scale used was: no vitritis=0, mild=1, moderate=2, severe=3. Group1 had 7/13 (53.85%) phakic eyes vs. group 2 with 5/10 (50%). No significant difference was found between the following characteristics in the two groups: lens status, presence of hypopyon or degree of vitritis at presentation. However, initial VA of LP or worse was more common in the PPV+IVitAb group (p=0.0361, odds ratio=9). Also, initial treatment selection of PPV + IVitAb (13 patients) vs. IVitAb (11 patients) did not result in a statistically significant different mean final VA (1.96 vs. 1.86 respectively, p=0.76).
In this cohort the choice of initial treatment did not affect final VA outcomes. Initial and final VA were poor in these eyes presenting with endophthalmitis. Characteristics of patients in each group did not differ significantly except for initial VA suggesting that VA may be one of the important factors influencing type of initial treatment chosen. Limitations of the study include low power (24 subjects) and the retrospective nature of the analysis.
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