Pars Plana Vitrectomy for Endophthalmitis: Microbiologic Spectrum and Clinical Outcomes

Lee, Chang Sup; Khan, Miraj Ali; Patrie, Jim; Bajwa, Asima; Shildkrot, Yevgeniy

doi:10.1080/09273948.2019.1698750

Cited by 9 publications

(6 citation statements)

References 35 publications

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“…This is not very surprising, as the same findings appear in the literature: eye pain [11], bacterial identification [29,48,49], and poor initial BCVA [11,25,26,29,30,33,50]. Other factors that have been reported as risk factors include: younger age (<85 years) [21], female sex [30], presence of an intraocular foreign body [25], a higher number of intravitreal injections [25,30], the type of injury (rupture) [26], retinal detachment [26,48], and proliferative vitreoretinopathy [26]. The most important risk factor for visual impairment at 12 weeks was poor initial BCVA.…”

Section: Discussionsupporting

confidence: 77%

“…In the present analyses, three factors (presence of eye pain, bacterial identification, and poor initial BCVA) significantly contributed to legal blindness, which suggests that a severe condition at baseline is a risk factor for later visual impairment. This is not very surprising, as the same findings appear in the literature: eye pain [11], bacterial identification [29,48,49], and poor initial BCVA [11,25,26,29,30,33,50]. Other factors that have been reported as risk factors include: younger age (<85 years) [21], female sex [30], presence of an intraocular foreign body [25], a higher number of intravitreal injections [25,30], the type of injury (rupture) [26], retinal detachment [26,48], and proliferative vitreoretinopathy [26].…”

Section: Discussionmentioning

confidence: 58%

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Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST

et al. 2021

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Bacterial endophthalmitis is an intraocular infection that causes rapid vison loss. Pathogens can infect the intraocular space directly (exogenous endophthalmitis (ExE)) or indirectly (endogenous endophthalmitis (EnE)). To identify predictive factors for the visual prognosis of Japanese patients with bacterial endophthalmitis, we retrospectively examined the bacterial endophthalmitis characteristics of 314 Japanese patients and performed statistics using these clinical data. Older patients, with significantly more severe clinical symptoms, were prevalent in the ExE group compared with the EnE group. However, the final best-corrected visual acuity (BCVA) was not significantly different between the ExE and EnE groups. Bacteria isolated from patients were not associated with age, sex, or presence of eye symptoms. Genus Streptococcus, Streptococcus pneumoniae, and Enterococcus were more prevalent in ExE patients than EnE patients and contributed to poor final BCVA. The presence of eye pain, bacterial identification, and poor BCVA at baseline were risk factors for final visual impairment.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 58%

Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST

et al. 2021

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“…This is consistent with the ranges of RRD after endophthalmitis reported in the literature (up to 25%). 4,8,9 The statistically significant risk factors for RRD in our study were aphakia, endogenous etiology, posterior synechia, and initial treatment, with PPV showing the highest incidence of RRD postoperatively. Compared with other studies that analyzed the risk factors for RRD after treatment, this both confirms some previous findings and creates some interesting dichotomies in findings.…”

Section: Discussionmentioning

confidence: 61%

Characteristics and Risk Factors for Rhegmatogenous Retinal Detachment Related to Endophthalmitis

Baxter,

Mccandless,

Lin

2024

Journal of VitreoRetinal Diseases

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Purpose: To evaluate the risk factors for the development of concurrent or delayed-onset rhegmatogenous retinal detachment (RRD) related to endophthalmitis as well as the anatomic and visual outcomes with subsequent RRD repair. Methods: In this retrospective case study, a 2-tailed t test (continuous) and Fisher exact test were used to determine statistical significance of the observed findings. The relative risk (RR) and 95% confidence intervals (CIs) were calculated to assess statistical significance. Results: Of the 170 patients included, 22 were found to have a concurrent or subsequent RRD. Initial treatment with pars plana vitrectomy (PPV) (RR, 3.544; 95% CI, 1.650-7.614), aphakia (RR, 4.150; 95% CI, 1.434-12.011), endogenous endophthalmitis (RR, 2.684; 95% CI, 1.065-6.764), and posterior synechiae (RR, 3.026; 95% CI, 1.408-6.505) were statistically significant risk factors for RRD. Anatomically successful repair was achieved in 77.7% of patients. Conclusions: In addition to preexisting risk factors, the initial treatment of endophthalmitis may be a significant risk factor for RRD development, with a higher incidence of subsequent RRD in patients who have PPV as the initial treatment of endophthalmitis.

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“…It should be mentioned that possibility of postoperative uveitis or toxic anterior segment syndrome (TASS) is considerable in this condition. However, clinical response to antibiotics is a differentiating factor [ 18 ]. It has been shown that the most common detected organisms in culture-positive endophthalmitis cases following cataract surgery are the Gram-positive organisms, which are responsible for 95% of culture-positive results.…”

Section: Discussionmentioning

confidence: 99%

“…This finding can be related to the more production of exotoxins by Streptococcal species [ 24 ]. In a study by Lee et al [ 18 ], culture-positive cases of post operative endophthalmitis had worse visual outcomes and higher rates of complication with RD compared to negative-culture eyes. Our results were in the same direction.…”

Section: Discussionmentioning

confidence: 99%

Early and complete vitrectomy versus tap and inject in acute post cataract surgery endophthalmitis presenting with hand motion vision; a quasi-experimental study

et al. 2022

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Background Based on endophthalmitis vitrectomy study, intravitreal injection of antibiotics is preferred for initial management of cases of acute post cataract surgery endophthalmitis (APCE) with presenting vision of hand motions (HM). This study aimed to compare outcomes of early and complete vitrectomy (VIT) and vitreous tap and antibiotic injection (T&I) in cases of APCE presented with vision of HM. Methods In this prospective study, cases of APCE with vision of HM between 2018 and 2020 were enrolled. According to the time of presentation, the patients were arranged into two groups (VIT vs. T&I). Demographic data, elapsed time to developing endophthalmitis, past medical history, microbiology results, complications, and final visual acuity were recorded and analyzed. Results Seventy-six eyes of 76 patients were enrolled. Fifty-three eyes underwent T&I and twenty-three were arranged into the VIT group. Past medical history of 34.2% of patients was significant for diabetes mellitus. There was a statistically significant lower logMAR in VIT group compared to T&I group (diff = 0.14, 95% CI: 0.04 to 0.24, P-value = 0.007). The comparison of the diabetic and non-diabetic patients in both groups showed that the visual outcome was better in non-diabetic cases compared to the diabetic subjects. There was no statistically significant difference between the diabetic and non-diabetic groups regarding the superiority of procedure. Conclusion Based on our results, we could recommend that it’s maybe better to do early and complete vitrectomy as the initial management of APCE with the vision of HM. Past medical history of diabetes mellitus is not a determining factor for choosing initial management between vitrectomy and antibiotic injection.

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Pars Plana Vitrectomy for Endophthalmitis: Microbiologic Spectrum and Clinical Outcomes

Cited by 9 publications

References 35 publications

Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST

Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST

Characteristics and Risk Factors for Rhegmatogenous Retinal Detachment Related to Endophthalmitis

Early and complete vitrectomy versus tap and inject in acute post cataract surgery endophthalmitis presenting with hand motion vision; a quasi-experimental study

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