Purchase this article with an account.
H. Ozaki, J. Y. Huang, M. Kozawa, H. Kondo, H. Hayashi, E. Uchio; Incidence and Outcome of Endophthalmitis After Pars Plana Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6041.
Download citation file:
© 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 on a total of 8860 eyes including combined cataract surgery, with or without the implantation of intraocular lens (IOL), which underwent PPV at Fukuoka University Hospital between April, 1985 and September, 2009 at Fukuoka University and 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 endophthalmitis. In addition, medical records were reviewed of all patients who developed acute endophthalmitis associated with PPV.
The overall incidence of endophthalmitis was 6/8860 eyes (0.07%). Total eyes of 8486 underwent the 20-guage PPV and a total of 374 eyes underwent 25-guage 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 5/8486, (0.06%) in the 20-guage PPV, and 1/374 (0.26%) in the 25-guage PPV. The days to the onset ranged from one to eight days, average 3.3 days. Treatment by PPV and perfusion of antibiotics was performed at the detection of endophthalmitis. Coagulase-negative Staphylococcus was isolated in 2 cases and Pseudomonas aeruginosa was isolated in one case. Cultures were negative in 2 cases. Two eyes had final visual acuity of 20/20 (33.3%) or better, three had visual acuity of 20/40 ~ 20/200 (50.0%), and one eye (16.7%) resulted in no light perception.
The incidence of endophthalmitis after pars plana vitrectomy was 0.07% with a higher rate in the 25-gauge PPV which is four times more than the 20-gauge PPV in this study. Prompt surgical intervention with simultaneous perfusion of antibiotics resulted in a quick resolution of endophthalmitis and a better visual outcome.
This PDF is available to Subscribers Only