Purchase this article with an account.
H. Nakashizuka, H. Shimada, M. Nakajima, S. Kiryu, Y. Sato; Prognosis of Pars Plana Vitrectomy Without IOL Removal for Endophthalmitis After Cataract Surgery With IOL Implantation . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1851.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the prognosis of pars plana vitrectomy without intraocular lens (IOL) removal for endophthalmitis after cataract surgery with IOL implantation. Methods: The subjects were 15 eyes of 14 patients with endophthalmitis after cataract surgery. They underwent pars plana vitrectomy without IOL removal for endophthalmitis consecutively between 1994 and 2002 at Surugadai Hospital of Nihon University. The mean age at surgery was 68.3±10.7 years and follow-up period after the vitrectomy was 11.6±5.8 months. The surgical methods included removal of fibrin nets in the anterior chamber. And after posterior capsulotomy by vitreous cutter, vitrectomy included vitreous base was performed with taking care to avoid iatrogenic retinal tear using inraocular irrigation solution with antibiotics (CEZ50µg/ml+GM10µg/ml). Visual acuity before and after the vitrectomy, complications during initial cataract surgery, the interval between cataract surgery and onset of endophthalmitis, the interval between onset of endophthalmitis and vitrectomy, existence of hypopyon and retinal disorders, bacterial culture and recurrence of endophthalmitis were reviewed from clinical records. Results: In terms of cataract surgery, phacoemulsification was performed in 13 eyes and extracapsular extraction in 2 eyes. Posterior capsular rupture and vitreous loss occurred in 5 eyes and wound leak in 1 eye. The interval between initial cataract surgery and the onset of endophthalmitis ranged from 1 day to 37 months (mean ± S.D.; 92±282 days). The interval between the onset of endophthalmitis and vitrectomy ranged from 1 to 17 days (4.5±5.6 days). At the onset of endophtalmitis, hypopyon and retinal disorders such as retinal hemorrhage or vasculitis were observed in 13 eyes. Bacterial cultures were positive in 6 eyes. Two patients underwent vitrectomy twice because of the recurrence of endophthalmitis at 2 months after the initial vitrectomy, resulting in cure without IOL removal. Visual acuity before the vitrectomy ranged from light perception to 0.3, and that after the surgery ranged from 0.06 to 1.5. Final visual acuity of 0.5 or better was achieved in 13 eyes. Conclusions: In the early period of the onset of endophthalmitis after cataract surgery, vitrectomy without IOL removal was a successful strategy and can preserve good vision.
This PDF is available to Subscribers Only