Abstract
BackgroundEndophthalmitis is a rare but severe complication following PPV. The incidence of endophthalmitis varies between 20-gauge, 23-gauge, and 25-gauge incisions. The incidence and clinical features of endophthalmitis after 23-gauge PPV in an eye hospital in China was reported in this study.MethodsData of the eyes that underwent 23-gauge PPV from January 2011 to December 2014 at the Eye Hospital of Wenzhou Medical University was retrospectively collected. All the information was obtained from the electronic medical system. The exclusion criteria included: (1) preoperative diagnosis of endophthalmitis; (2) history of vitrectomy; (3) intraocular surgery within 6 months; (4) history of ocular penetrating trauma; (5) sutures for any of the 3 sclerotomy incisions; (6) patients with cancer, acquired immune deficiency syndrome, or taking drugs that may influence the immune system. The diagnosis of endophthalmitis was based on clinical characteristics and/or culture results from an operative sample.ResultsThree thousand nine hundred seventy nine eyes that underwent 23-gauge PPV surgery were included in this study. Among these eyes, 3 eyes developed endophthalmitis after surgery, giving an incidence of 0.075% (3/3979). The period in which endophthalmitis developed ranged from 1 to 5 days post-operation. The visual acuity decreased to hand motions or light perception postoperatively. The culture of aqueous and vitreous of the 2 eyes revealed Staphylococcus epidermidis and enterococcus faecalis respectively, however was negative for the third eye. All 3 eyes had a favorable response to the treatment of vitreous tap and intravitreal antibiotics injection. Two eyes gained visual acuity of 0.05 and 0.5, respectively at the final visit.ConclusionsEndophthalmitis is a rare but sight-threatening complication after 23-gauge pars plana vitrectomy. The peak duration of onset was within 5 days post-operation, with gram positive cocci being the common pathogenic organism.
Highlights
Endophthalmitis is a rare but severe complication following pars plana vitrectomy (PPV)
Data which was gathered from a large prospective, nationwide case-control study suggested that the smallgauge vitrectomy did not increase the risk of endophthalmitis [11]
The purpose of this study is to report on the incidence of endophthalmitis after 23-gauge PPV, and to investigate the clinical settings, management strategies, causative organisms, and visual acuity outcomes for these cases
Summary
Endophthalmitis is a rare but severe complication following PPV. The incidence of endophthalmitis varies between 20-gauge, 23-gauge, and 25-gauge incisions. The incidence and clinical features of endophthalmitis after 23-gauge PPV in an eye hospital in China was reported in this study. Endophthalmitis is a vision-threatening complication following pars plana vitrectomy (PPV). The incidence of endophthalmitis after 20-gauge PPV was reported to be between 0.03 and 0.15% [1,2,3,4]. Scott et al reported a significantly higher incidence of endophthalmitis after 25-gauge PPV (0.84%) during 2005-2006, compared to 20-gauge PPV (0.03%) [5]. Data which was gathered from a large prospective, nationwide case-control study suggested that the smallgauge vitrectomy did not increase the risk of endophthalmitis [11]
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