Treatment of Propionibacterium Endophthalmitis

Teichmann, Klaus D.

doi:10.1016/s0161-6420(93)31406-5

Cited by 8 publications

(4 citation statements)

References 4 publications

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“…15 Other cases of resolution after intraocular antibiotics injected into the capsular bag or simultaneously into the aqueous and the vitreous have also been described. 13,16,17,18,19 Recurrence of inflammation in these patients may warrant PPV with partial capsulectomy or total capsulectomy, with or without removal or exchange of the IOL. In the current series, recurrence of disease was noted in 73% of delayed-onset patients after the initial procedure.…”

Section: Discussionmentioning

confidence: 99%

Delayed- Versus Acute-Onset Endophthalmitis After Cataract Surgery

Shirodkar¹,

Pathengay²,

Flynn³

et al. 2012

American Journal of Ophthalmology

101

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Purpose To report a large consecutive case series of patients who developed delayed-onset and acute-onset endophthalmitis after cataract surgery. Design Retrospective consecutive case series. Methods The current study is a retrospective consecutive case series of patients treated between January 2000 and December 2009 for culture-proven endophthalmitis after cataract surgery. The study defined two groups after cataract surgery: acute-onset endophthalmitis (≤ 6 weeks after surgery) and delayed-onset endophthalmitis (> 6 weeks after surgery). Results A total of 118 patients met study criteria and included 26 delayed-onset cases and 92 acute-onset cases. The following clinical features and outcomes occurred in delayed versus acute-onset cases: (1) the presenting visual acuity was ≤ 5/200 in 31% versus 89%, (2) hypopyon was found in 46% versus 80%, (3) the most frequent isolate was Propionibacterium acnes (11/26) versus coagulase-negative Staphylococcus (57/92), (4) patients with the most frequent isolate achieved a visual outcome of ≥ 20/100 in 91% versus 56%. In delayed-onset cases, the intraocular lens was removed or exchanged in 19/26 (73%). Of these 19 cases, 13 achieved a visual outcome of ≥ 20/100. Conclusions Patients with delayed-onset endophthalmitis generally presented with better initial visual acuities, had a lower frequency of hypopyon, and had better visual outcomes compared to acute-onset patients. Propionibacterium acnes and coagulase-negative Staphylococcus species were the most common organisms cultured in delayed and acute-onset categories, respectively, and were associated with the best visual acuity outcomes in each group.

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Section: Discussionmentioning

confidence: 99%

Delayed- Versus Acute-Onset Endophthalmitis After Cataract Surgery

Shirodkar¹,

Pathengay²,

Flynn³

et al. 2012

American Journal of Ophthalmology

101

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“…Two intraocular antibiotics injection approaches have been described either into the capsular bag or simultaneously into the aqueous and the vitreous [52, 53]. …”

Section: Treatment Strategies and Outcomesmentioning

confidence: 99%

Chronic Postoperative Endophthalmitis: A Review of Clinical Characteristics, Microbiology, Treatment Strategies, and Outcomes

Maalouf

Abdulaal

Hamam

2012

International Journal of Inflammation

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Chronic postoperative endophthalmitis (CPE) is a delayed infectious intraocular inflammation process that occurs more than six weeks after ocular surgery and frequently masquerades as autoimmune uveitis. These cases are at risk of delayed diagnosis and erroneous long-term treatment with corticosteroids. This paper aims to review the epidemiology, microbiology, clinical characteristics, diagnosis, management strategies, and outcome of chronic postoperative endophthalmitis. The incidence of CPE is still uncommon, and multiple pathogens have been reported with varying frequencies. Review of the literature reveals that CPE cases have a high incidence of visual impairment and recurrence rate might be decreased with aggressive surgical approach.

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“…[8][9][10][11] Vitrectomy with central capsulectomy and intracameral injection of antibiotics is recommended. 12,13 While explantation of IOL is not a standard recommendation in the management of acute endophthalmitis, IOL explantation could be an option in the management of delayed-onset endophthalmitis.…”

Section: Discussionmentioning

confidence: 99%

<p>Clinical Presentations and Comparative Outcomes of Delayed-Onset Low-Grade Endophthalmitis Managed with or Without Intraocular Lens Explantation</p>

Dave¹,

Parmeshwarappa²,

Dogra³

et al. 2020

OPTH

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Purpose: To compare the outcomes of delayed-onset low-grade endophthalmitis managed with and without intraocular lens (IOL) explantation. Setting: Tertiary eye-care research institute in southern India. Design: Retrospective comparative case series. Methods: The study included all cases of post-cataract surgery delayed-onset endophthalmitis from January 1990 to January 2019. Time to endophthalmitis, duration of symptoms, presenting visual acuity, time to IOL explantation when performed, resolution after explantation, number of intravitreal injections, and final visual acuity were compared in the IOL nonexplanted and IOL explanted groups. Results: There were 115 eyes-61 eyes in the IOL non-explant and 54 eyes in the IOL explant group. Between the two groups there was no statistically significant difference in age (58.37 ± 14.05 and 56.04 ± 14.96 years, respectively; p=0.35), vision at presentation (>20/400 in 29.5% and 29.6% eyes, respectively; p=0.98), and the duration of follow-up (14.38 ± 16.05, median 8.5 months and 7.06 ± 3.55, median 6 months respectively; p=0.43). There was a statistically significant difference between the IOL non-explant and IOL-explant groups in the time to resolution of inflammation (92.70 ± 36.28 and 45.33±11.2 days, respectively; p <0.0001) and the number of intravitreal injections (4.57 ± 0.75, median 5 and 2.79 ±2.11, median 2 respectively, p=0.005). Persistent/recurrent inflammation at 6 months was recorded in 18.03% and 5.55% in the IOL non-explant and IOL explant eyes, respectively (p=0.04). Favorable functional outcome was seen in 50.81% vs 68.51% in IOL non-explant and explant eyes, respectively (p=0.05). Conclusion: IOL explantation in delayed-onset endophthalmitis helps in earlier resolution of inflammation, need for lesser number of intravitreal injections and a trend towards better functional outcomes.

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Treatment of Propionibacterium Endophthalmitis

Cited by 8 publications

References 4 publications

Delayed- Versus Acute-Onset Endophthalmitis After Cataract Surgery

Delayed- Versus Acute-Onset Endophthalmitis After Cataract Surgery

Chronic Postoperative Endophthalmitis: A Review of Clinical Characteristics, Microbiology, Treatment Strategies, and Outcomes

<p>Clinical Presentations and Comparative Outcomes of Delayed-Onset Low-Grade Endophthalmitis Managed with or Without Intraocular Lens Explantation</p>

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