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Vitrectomy for endophthalmitis: 5-year study of outcomes and complications
  1. Guy Simon Negretti1,
  2. WengOnn Chan2,
  3. Carlos Pavesio3,
  4. Mahiul Muhammed Khan Muqit1,4
  1. 1Department of Vitreoretinal Surgery, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  2. 2South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  3. 3Moorfields Eye Hospital NHS Foundation Trust, London, UK
  4. 4Institute of Ophthalmology, University College London, London, United Kingdom
  1. Correspondence to Mr Mahiul Muhammed Khan Muqit; mahi.muqit1{at}nhs.net

Abstract

Background/Aims To analyse the complications and outcomes of vitrectomy surgery for endophthalmitis.

Methods This was a retrospective case series. All cases that underwent 23-gauge vitrectomy surgery for endophthalmitis at a tertiary centre between 1 February 2013 and 1 February 2018 were included. Main outcome measures were as follows: visual acuity (VA) at final visit and post-vitrectomy complications.

Results 33 patients were included in the study with 20 men and 13 women, average age 63 years. Main post-surgical causes for endophthalmitis included phacoemulsification (n=9), trabeculectomy (n=5), intravitreal injection (n=5), corneal graft (n=4), vitreoretinal surgery (n=3) and endogenous endophthalmitis (n=6). Average follow-up was 18 months (SD 14). 21/33 (64%) patients had baseline perception of light VA. Analysis of exogenous endophthalmitis cases only demonstrated: mean LogMAR VA improved significantly from 2.68 to 1.66 (p=0.001). At final follow-up, 12% had VA of 6/12 or better, and 28% had VA of 6/36 or better. Vitrectomy within 7 days resulted in improved final VA outcomes (1.49 vs 2.16 LogMAR, p=0.032). Complications included retinal detachment (24.2%), macular hole (3%), hypotony (6%), suprachoroidal haemorrhage (3%) and enucleation/evisceration (6%).

Conclusion Vitrectomy for endophthalmitis leads to VA gains in some cases. Surgical outcomes may be improved with early vitrectomy performed within 7 days of the initial event for exogenous endophthalmitis. Patients should be advised of the potential risk of severe complications with/and without surgery.

  • treatment surgery
  • retina
  • infection
  • inflammation
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Footnotes

  • Contributors Study design, planning, conduct, analysis of data and reporting of work: GN, WOC, CP, MMMK. We confirm that GN and MMMK are responsible for the overall content as guarantors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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