Endophthalmitis: Changes in Presentation, Management and the Role of Early Vitrectomy

Shao, Emily Han; Yates, William B.; Ho, I-Van; Chang, Andrew; Simunovic, Matthew P.

doi:10.1007/s40123-021-00406-6

Cited by 20 publications

(15 citation statements)

References 72 publications

(90 reference statements)

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“…The patient had a slight improvement in VA, from counting finger (CF) to 20/1000. The prognosis of endophthalmitis varies according to the species of pathogenic microorganisms [17][18] . The prognosis of bacterial is often poor.…”

Section: Endogenous Endophthalmitismentioning

confidence: 99%

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Microbial spectrum and risk factors of endogenous endophthalmitis in a tertiary center of Northern China

Gan¹,

Zhou²,

Min³

et al. 2022

Int J Ophthalmol

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AIM: To study the clinical features, microbial spectrum, associated factors and prognosis of endogenous endophthalmitis (EE) in a group of Chinese patients. METHODS: The medical records from 32 eyes of 29 patients diagnosed with EE in Peking Union Medical College Hospital from January 2009 to October 2019 were reviewed. RESULTS: The initial visual acuity (VA) of 30 eyes in this study was worse than 20/400. Twenty-three eyes were diagnosed with fungal endophthalmitis and nine with bacterial endophthalmitis. The most common fungal and bacterial isolates were Candida and Klebsiella pneumoniae, respectively. Several rare fungi and bacteria species were also isolated from our patients, including Cryptococcus, Paecilomyces, Brucella, and Bacillus licheniformis. The leading risk factor for EE was diabetes. The most common extraocular infection locus was genitourinary tract. Vitrectomy was performed on twenty-nine eyes. Eight eyes achieved final VA of 20/400 or better. EE caused by Candida had a better prognosis. CONCLUSION: The visual outcome of EE is based on pathogens and prompt intervention. Early vitrectomy and antimicrobial treatment are beneficial for EE.

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Section: Endogenous Endophthalmitismentioning

confidence: 99%

“…The initial VA was an important factor for VA outcomes [7,21] . Early vitrectomy, together with systemic and intravitreal antiinfective agents, is the most effective treatment of EE [1,[17][18]22] . The treatment course for bacteria EE was three months in our hospital, and for fungal EE was 4-6mo.…”

Section: Endogenous Endophthalmitismentioning

confidence: 99%

Microbial spectrum and risk factors of endogenous endophthalmitis in a tertiary center of Northern China

Gan¹,

Zhou²,

Min³

et al. 2022

Int J Ophthalmol

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“…Endophthalmitis is the most feared postoperative complication for the most popular eye surgery, phacoemulsification. Several measures are taken in every surgery as prophylaxis against endophthalmitis, starting from treating any signs of ocular surface infection promptly and sterilizing the conjunctival sac 3 mins before surgery by using 3-5% betadine for the elimination of the conjunctival flora, the most common source of organisms responsible for endophthalmitis, in addition to sterilization of the operative theatre environment and the instruments used, and putting an Opsite drape to exclude the lid margin from the operative field is an essential step [4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…Injecting intracameral antibiotics at the end of surgery is a rising measure in prophylaxis against endophthalmitis. Its safety and efficacy made it a routine step in eye centers worldwide [4][5][6]. In 2007, the European society of cataract and refractive surgery published a multicenter randomized clinical trial that assessed the efficacy of using the intracameral injection of antibiotics for prophylaxis against endophthalmitis post-cataract surgery, the study included 13598 patients from 24 European centers.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Endophthalmitis After Intra-Operative Moxifloxacin Injection in the Capsular Bag, Behind the Intra Ocular Lens, in Phacoemulsification. A Retrospective Study

Mostafa

Sameh²,

Altak³

et al. 2022

Egyptian Journal of Clinical Ophthalmology

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Purpose: to evaluate the efficacy and safety of intracapsular moxifloxacin injection at the end of phacoemulsification as a prophylactic measure against early and late endophthalmitis. Setting: private eye center, eye Care, Cairo, Egypt. Methods: This is a retrospective clinical registry-based study. Data was collected from patients who had phacoemulsification within the capsular bag injection of moxifloxacin at the end of surgery. 0.2 ml of moxifloxacin 0.5% ophthalmic solution was injected into the bag by placing the tip of the cannula under the capsulorhexis edge and directing the drug behind the IOL. Results: Data were collected from EMR for 10919 eyes, that underwent phacoemulsification and in the bag moxifloxacin injection between January 2015 and August 2022, 4 cases of early endophthalmitis were reported with an incidence of 0.03%, no cases of late-endophthalmitis, and no cases of toxicity. Conclusion: Intracapsular moxifloxacin injection at the end of phacoemulsification is a safe effective prophylactic measure against endophthalmitis.

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“…Conjunctivitis, blepharitis, prior history of recurrent bleb infection, and chronic use of topical antibiotics are all strongly associated with increased risk for BRI [ 28 , 29 , 34 ]. Another interesting finding when assessing risk factors for BRI is the role of phacoemulsification when combined with glaucoma filtration surgery.…”

Section: Other Risk Factorsmentioning

confidence: 99%

A Review on Pathogens and Necessary Diagnostic Work for Bleb-Related Infections (BRIs)

et al. 2022

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At the present time, as newer techniques and minimally invasive procedures gain popularity among anterior segment surgeons for regulating intraocular pressure, trabeculectomy still has a leading role in glaucoma surgery. Trabeculectomy retains a highly successful and safe profile; however, one of the major complications includes bleb-related infections (BRIs). To date, the most common pathogens remain Gram-positive cocci, but the list of pathogens that have been identified in the literature includes more than 100 microorganisms. Because antibiotic use is more widespread than ever before and our ability to identify pathogens has improved, the pathogen spectrum will broaden in the future and more pathogens causing BRIs will be described as atypical presentations. The scope of this review was to identify all pathogens that have been described to cause bleb-related infections to date, as well as focus on the risk factors, clinical presentation, and various available diagnostic tools used for an appropriate diagnostic workup.

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Endophthalmitis: Changes in Presentation, Management and the Role of Early Vitrectomy

Cited by 20 publications

References 72 publications

Microbial spectrum and risk factors of endogenous endophthalmitis in a tertiary center of Northern China

Microbial spectrum and risk factors of endogenous endophthalmitis in a tertiary center of Northern China

Incidence of Endophthalmitis After Intra-Operative Moxifloxacin Injection in the Capsular Bag, Behind the Intra Ocular Lens, in Phacoemulsification. A Retrospective Study

A Review on Pathogens and Necessary Diagnostic Work for Bleb-Related Infections (BRIs)

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