Risk Factors for Endophthalmitis after Pars Plana Vitrectomies in a Tertiary Eye Institute in India

Bhende, Muna; Raman, Rajiv; Singh, Niharika; Jain, Mukesh; Sharma, Tarun; Gopal, Lingam; Bhende, Pramod; Srinivasan, Sangeetha; Malathi, Jambulingam

doi:10.1016/j.oret.2018.01.001

Cited by 7 publications

(8 citation statements)

References 23 publications

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“…Among the microorganisms isolated in the 24 culture-positive cases, Aspergillus was the only fungus isolated (5/24; 20.8%). Conversely, the article compared the incidence rates of endophthalmitis in both 20 G PPV and mini-invasive approach PPV, demonstrating a higher incidence of endophthalmitis in 20 G PPV (0.057% vs. 0.012%) [22]. The same study suggests a protective role of intraocular tamponade [21].…”

Section: Endophthalmitis Post-vitrectomymentioning

confidence: 96%

“…Mould infections after vitrectomy remain a rare event with high variability between temperate to tropical zones, and high heterogeneity of epidemiological data between hospitals [21]. In a single, tertiary eye care in India [22], of 111,876 pars plana vitrectomy (PPV) performed, 45 cases developed acute onset postoperative endophthalmitis. Among the microorganisms isolated in the 24 culture-positive cases, Aspergillus was the only fungus isolated (5/24; 20.8%).…”

Section: Endophthalmitis Post-vitrectomymentioning

confidence: 99%

“…Perikeratic reaction is a possible ocular finding as well as keratic precipitates, hypopyon and fibrinous anterior chamber (AC) exudation [3]. Scleritis has been reported as a presentation finding of EXFE following PPV [21][22][23].…”

Section: Clinical Featuresmentioning

confidence: 99%

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Exogenous Fungal Endophthalmitis: Clues to Aspergillus Aetiology with a Pharmacological Perspective

et al. 2020

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Exogenous fungal endophthalmitis (EXFE) represents a rare complication after penetrating ocular trauma of previously unresolved keratitis or iatrogenic infections, following intraocular surgery such as cataract surgery. The usual latency period between intraocular inoculation and presentation of symptoms from fungal endophthalmitis is several weeks to months as delayed-onset endophthalmitis. Aspergillus spp., is the most common causative mould pathogen implicated in this ocular infection and early diagnosis and prompt antimicrobial treatment, concomitantly in most cases with expert surgical attention, reduce unfavorable complications and increase the possibility of eye function preservation. Topical, intravitreal and systemic antifungal molecules are the mainstay of a medical approach to the disease and azoles, polyenes and in particular cases echinocandins are the pharmacological classes most commonly used in clinical practice. This review discusses pharmacokinetics and pharmacodynamic of antifungal agents in their principal modes of administration with a focus on their ability to achieve high drug concentration in the vitreous and ocular tissues.

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Section: Endophthalmitis Post-vitrectomymentioning

confidence: 96%

Section: Endophthalmitis Post-vitrectomymentioning

confidence: 99%

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Exogenous Fungal Endophthalmitis: Clues to Aspergillus Aetiology with a Pharmacological Perspective

et al. 2020

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“…Acute infectious endophthalmitis, an infrequent but severe complication of PPV, is linked to pre-existing systemic immunosuppression, pseudophakia, aphakia, and use of topical steroids prior to surgery [26,27]. Inadequate wound closure leading to ocular hypotony and ingress of surface bacteria is the main predisposing risk factor for endophthalmitis [28].…”

Section: Subretinalmentioning

confidence: 99%

“…Inadequate wound closure leading to ocular hypotony and ingress of surface bacteria is the main predisposing risk factor for endophthalmitis [28]. The proper technique involves conjunctival displacement and angled sclerotomy [27]. Meticulous examination of sclerotomy sites requiring suturing is crucial to preventing leakage and inoculation of flora into the vitreous.…”

Section: Subretinalmentioning

confidence: 99%

Treatment-Emergent Adverse Events in Gene Therapy Trials for Inherited Retinal Diseases: A Narrative Review

et al. 2020

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Patient safety is a primary priority in the conduction of retinal gene therapy trials. An understanding of risk factors and mitigation strategies for post-procedure complications is crucial for the optimization of gene therapy clinical trial protocols. In this review, we synthesize the literature on ocular delivery methods, vector platforms, and treatment-emergent adverse effects in recent gene therapy clinical trials for inherited retinal diseases.

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Preventive factors, diagnosis, and management of injection-related endophthalmitis: a literature review

Singh

Davoudi

Ness

2022

Graefes Arch Clin Exp Ophthalmol

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Background Intravitreal medication injections represent the gold standard treatment for a variety of potentially blinding chorioretinal vascular diseases. Despite their excellent safety profile, they are associated with the feared complication of injection-related endophthalmitis (IRE). Though the overall incidence of IRE is low, due to the ever-increasing number of injections being performed, it is a complication that all retina specialists are likely to encounter. This article reviews various factors that could potentially influence the risk of IRE and discusses evidence-based strategies for management. Method PubMed was searched for keywords “intravitreal injection” and “endophthalmitis” from the period of 1995–2021. Relevant articles were reviewed and selected articles were analyzed with respect to the incidence, potential preventive factors, clinical presentation, microbial profile, management, and outcomes for IRE. Results There is strong consensus supporting the use of povidone iodine topical antiseptic, eyelid retraction away from the injection site, and avoiding treatment of eyes with active surface or eyelid disease, but there is less agreement on the use of face masks versus “no-talking” policies and optimal anesthetic technique. Current evidence comparing tap and inject or early vitrectomy for treatment of IRE is inadequate to determine an optimal treatment strategy. Conclusion Intravitreal injections are sight saving, but even using established prophylactic measures there remains a small but real risk of infectious injection-related complications. Further investigations comparing tap and inject versus vitrectomy may help to establish optimal treatment, although the rarity of IRE makes designing adequately powered prospective trials a difficult task.

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Risk Factors for Endophthalmitis after Pars Plana Vitrectomies in a Tertiary Eye Institute in India

Cited by 7 publications

References 23 publications

Exogenous Fungal Endophthalmitis: Clues to Aspergillus Aetiology with a Pharmacological Perspective

Exogenous Fungal Endophthalmitis: Clues to Aspergillus Aetiology with a Pharmacological Perspective

Treatment-Emergent Adverse Events in Gene Therapy Trials for Inherited Retinal Diseases: A Narrative Review

Preventive factors, diagnosis, and management of injection-related endophthalmitis: a literature review

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