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H. Ozaki, J. Y. Huang, M. Kozawa, N. Umeda, N. Arita, H. Migita, H. Kondo, H. Hayashi, E. Uchio; Incidence and Outcome of Endophthalmitis After Pars Plana Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3562.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the incidence, causative organism, and visual outcome of endophthalmitis after 20-gauge and 25-gauge pars plana vitrectomy (PPV).
This is a retrospective study of 8489 eyes underwent PPV (20-gauge and 25-gauge) at Fukuoka University Hospital between April 1, 1985 and November 30, 2008. Combined cataract surgeries with or without the implantation of intraocular lens (IOL) were included. The incidence of acute endophthalmitis following PPV was determined. Endophthalmitis associate with open-globe injury was excluded. PPV with perfusion of antibiotics was immediately performed at the time of presentation of signs of endophthalmitis. Those with lens or IOL were extracted at the time of secondary PPV. Aqueous samples were cultured for causative microorganism. Treatment outcome was determined by the final visual acuity. Furthermore, medical records were reviewed of all patients who developed acute endophthalmitis associated with PPV.
The overall incidence of endophthalmitis was 6/8489 eyes (0.07%). Total of 8286 eyes underwent a 20-gauge PPV and a total of 203 eyes underwent a 25-gauge PPV. The average age was 56.3 years old. The indication of initial vitrectomy was idiopathic macular hole (n=2), macular epiretinal membrane (n=2), proliferative diabetic retinopathy(n=1), and branch retinal vein occlusion (n=1). The incidence was determined to be 5/8286, (0.06%) in the 20-gauge PPV, and 1/203 (0.49%) in the 25-gauge PPV. The days to the onset ranged from one to eight days (average 3.3 days). Coagulase-negative Staphylococcus was isolated in 2 cases and Pseudomonas aeruginosa was isolated in one case. Cultures were negative in 3 cases. Two eyes (33%) had final visual acuity of 20/20 or better, three (50%) had visual acuity of 20/40 ~ 20/200, and one eye (17%) resulted in no light perception.
The incidence of endophthalmitis after pars plana vitrectomy was 0.07%. Prompt surgical intervention with simultaneous perfusion of antibiotics during vitrectomy resulted in a quick resolution of endophthalmitis and a better visual outcome.
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