Treatment of Bacillus cereus endophthalmitis with endoscopy-assisted vitrectomy

Abstract

To evaluate the use of endoscopy-assisted vitrectomy in patients with sight-threatening Bacillus cereus endophthalmitis.A retrospective analysis was conducted in 15 eyes with Bacillus cereus endophthalmitis. Patients were divided into 2 groups: endoscopy-assisted vitrectomy (5 eyes) and conventional vitrectomy (10 eyes). The following clinical data were recorded and analyzed: sex, age, latent period, symptom duration, follow-up time, visual acuity pre- and postsurgery, recurrence of endophthalmitis, incidence of phithisis bulbi, and incidence of enucleation.In the conventional vitrectomy group, postoperative visual acuity ranged from no light perception in 5 patients (50%), light perception in 3 patients (30%), 20/1000 in 1 patient (10%), and 20/50 in 1 patient (10%). In the endoscopy-assisted vitrectomy group, postoperative visual acuity ranged from no light perception in 2 patients (40%), light perception in 1 patient (20%), and hand movements in 2 patients (40%). There was no statistically significant difference between the 2 groups in terms of the final postoperative visual acuity (F = 0.006, P = .937). There is no difference between the 2 groups in terms of the incidence of enucleation. The median symptom duration was 4 hours (range: 2–6 hours) in the conventional group and 9 hours (range: 7–11 hours) in the endoscopy-assisted vitrectomy group. The difference in the symptom duration between the 2 groups was statistically significant (P = .002).There is no statistical significant difference between the 2 groups in terms of visual acuity and incidence of enucleation. Therefore, endoscopy-assisted vitrectomy can be considered as an alternative treatment for treatment of B cereus endophthalmitis particularly for cases when symptom duration was more than 6 hours.

Posttraumatic Bacillus cereus Endophthalmitis: Clinical Characteristics and Antibiotic Susceptibilities

“…Previous reports have shown that posttraumatic Bacillus cereus endophthalmitis can cause complete corneal opacification within 24 hours of injury [ 32 ]. Pan et al recommended endoscopy-assisted vitrectomy as an alternative treatment for Bacillus cereus endophthalmitis [ 24 ].…”

“…In recent years, vitrectomy has been used to treat Bacillus cereus endophthalmitis. For example, Pan et al reported 15 patients with Bacillus cereus endophthalmitis treated by vitrectomy with or without endoscopy assistance; however, four of them underwent enucleation [ 24 ]. There is no doubt that early application of sensitive antibiotics is helpful in controlling infections.…”

Endoscopy-Assisted Vitrectomy Outcomes During Silicone Oil Removal After Complex Retinal Detachment Repair

“…Advantages of endoscopy in cases of media opacity are well established (endophthalmitis, trauma); [19][20][21][22][23] nonetheless, a broader number of indications for endoscopy exists when used as "endoscopy-assisted" vitrectomy. 6,18,[24][25][26][27][28][29] We propose the use of endoscopy to perform a detailed endoscopic revision during SO extraction in complex RDs.…”

A Pyrrhic Victory: The PMN Response to Ocular Bacterial Infections

“…( C ) A patient with post-operative E. faecalis endophthalmitis presents with exudative membrane and infiltrates, ocular injection, and a hypopyon. This figure is reproduced under a Creative Commons Attribution-NonCommercial-ShareAlike License from © 2019 Indian Journal of Ophthalmology [158], the Creative Commons Attribution-ShareAlike License 4.0 from © 2017 Medicine [159], and the Creative Commons Attribution-NonCommercial 3.0 Unported from © 2015 J Korean Ophthalmol Soc [160].…”