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P.O. Lafontaine, F. Rouberol, P.L. Cornut, A.M. Bron, G. Thuret, J.P. Romanet, C. Creuzot–Garcher, C. Chiquet; Complications of Pars Plana Vitrectomy in Acute Endophthalmitis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5489.
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Purpose: To assess the results and the complications of vitrectomies performed in acute endophthalmitis. Methods: Forty–eight patients aged from 22 to 96 years old (69± 16) were included in this multicenter prospective study. All patients hospitalized from January 2001 to August 2004 for an acute postoperative endophthalmitis and undergoing a vitrectomy as part of their treatment were enrolled. Acute endophthalmitis was diagnosed after cataract surgery (n=40), glaucoma surgery (n=2), keratoplasty (n=1), radial keratotomy (n=1) and penetrating ocular traumatism (n=4). Results: PCR or conventional bacteriologic cultures, in vitreous or/and aqueous humor were positive in 67% of the cases. Visual acuities were light perception (50%), hand motion (35.5%) or between 20/400 to 20/200 (14.5%) before vitrectomy. Vitrectomy was performed with a mean delay of 5.2 days after the onset of the hospitalization. Per operative complications were uncommon: vitreous IOL luxation (n=1), intra vitreous hemorrhages (n=2). Postoperative complications were phthisis (6%), retinal detachment (10.5%), irido–capsular synechiae (12.5%), epiretinal membrane (8%) and ocular hypertension (14.5%). Final visual acuities were 20/20 (8,5%), from 20/40 to 20/25 (21%), from 20/200 to 20/50 (31.5%), count fingers (16.5%), hand motion (6%), light perception (6%) and no light perception (10.5%). Conclusions: Vitrectomy performed as a treatment modality for endophthalmitis remains a difficult vitreous surgery due to the poor visibility of the posterior segment (cornea edema, anterior segment’s flare, vitreous opacities). The most frequent complications are similar to vitreous surgeries done in other indications than endophthalmitis i.e. retinal detachment, epiretinal membrane and ocular hypertension. Final visual impairment or blindness is mainly due to phthisis or untractable infection rather than vitrectomy.
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