June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Assessing the risk of hypopyon formation following mechanical vitrectomy
Author Affiliations & Notes
  • Ibraheem S Shaikh
    Rutgers New Jersey Medical School Institute of Ophthalmology and Visual Science, Newark, New Jersey, United States
  • Marko Oydanich
    Rutgers New Jersey Medical School Institute of Ophthalmology and Visual Science, Newark, New Jersey, United States
  • Musa S Shaikh
    New Jersey Institute of Technology, Newark, New Jersey, United States
  • Albert S Khouri
    Rutgers New Jersey Medical School Institute of Ophthalmology and Visual Science, Newark, New Jersey, United States
  • Footnotes
    Commercial Relationships   Ibraheem Shaikh, None; Marko Oydanich, None; Musa Shaikh, None; Albert Khouri, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 3633. doi:
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    • Get Citation

      Ibraheem S Shaikh, Marko Oydanich, Musa S Shaikh, Albert S Khouri; Assessing the risk of hypopyon formation following mechanical vitrectomy. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3633.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The formation of a hypopyon, a white blood cell exudate in the anterior chamber of the eye, is a previously reported but uncommon complication of mechanical vitrectomy (MV). Using a large sample population database, we investigated the impact of various clinical and non-clinical factors on the risk of developing hypopyon after MV.

Methods : Cases of MV were obtained from the National Inpatient Sample (NIS) database between 2002 and 2013. ICD-9 diagnosis and procedural codes were used to assess associated morbidities in cases with a principal procedure of MV. Perioperative complications occurring during the same operative admission were abstracted using ICD-9 codes, and secondary diagnoses of hypopyon were identified. Univariate and multivariate logistic regression analyses were carried out in cases that underwent MV to determine risk factors for the development of a hypopyon. The dataset was weighted using the NIS-provided discharge-level weights in order to achieve nationally representative estimates. The Bonferroni correction method was applied.

Results : There were 3,927 MV cases that were grouped into hypopyon (n=50, median age=76, 58% female) and non-hypopyon (n=3,877, median age=61, 49% female) cohorts. Co-morbid factors associated with increased risk of hypopyon formation included retinal vasculitis (OR=18.23), rheumatoid arthritis (OR=4.87), and tobacco use (OR=1.98). Younger age was strongly protective against hypopyon formation in the age groups 0-19 (OR=0.08), 20-39 (OR=0.10), 40-59 (OR=0.34), and 60-79 (OR=0.47) in comparison to the reference group of ≥80 years of age (Figure 1). Race, sex, and insurance status did not show statistically significant associations.

Conclusions : A large patient population was utilized to examine this rare complication following MV. We found an increased risk of hypopyon formation in cases that underwent MV with comorbidities associated with inflammatory states, including retinal vasculitis, rheumatoid arthritis, and tobacco use. Younger age was a protective factor, with an exponential increase in risk of hypopyon development associated with advancing age. Limitations of this study include the limited cases of MV in the inpatient setting, the use of a database that records cases rather than individual patients, and the limited ability to demonstrate casual relationships in a retrospective analysis.

This is a 2021 ARVO Annual Meeting abstract.

 

Figure 1: Significant factors for hypopyon development in cases that underwent MV

Figure 1: Significant factors for hypopyon development in cases that underwent MV

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