J Korean Ophthalmol Soc.  2015 Feb;56(2):213-218. 10.3341/jkos.2015.56.2.213.

Effect of Internal Limiting Membrane Peeling in Visual Outcome of Endophthalmitis after Pars Plana Vitrectomy

Affiliations
  • 1Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. eyedr@dsmc.or.kr

Abstract

PURPOSE
To evaluate the clinical course and prognostic factors of visual acuity in post-vitrectomy endophthalmitis.
METHODS
A total of 9 patients diagnosed with post-vitrectomy endophthalmitis between 2004 and 2013 were enrolled in this retrospective study. To evaluate factors affecting final visual acuity, the following was investigated: best corrected visual acuity (BCVA) before first vitrectomy, BCVA at presentation, presence of diabetes mellitus, type of port used on first pars plana vitrectomy, whether cataract operation was performed simultaneously, whether removal of internal limiting membrane was performed at first pars plana vitrectomy, interval period from initial vitrectomy to treatment of endophthalmitis, presence of hypopyon, whether culture was proven, and type of organism isolated.
RESULTS
All 9 eyes received intravitreal antibiotic injections and additional pars plana vitrectomy was performed in 7 eyes. Six eyes were culture-proven. Staphylococcus epidermidis was cultured from 5 eyes and Escherichia coli was cultured from 1 eye. BCVA before first vitrectomy, presence of diabetes mellitus, type of port used on first pars plana vitrectomy, whether cataract operation was performed simultaneously, interval from initial vitrectomy to treatment of endophthalmitis, whether culture proven, and type of organism isolated did not affect final visual acuity. BCVA at presentation was an important factor for final visual acuity. Removal of internal limiting membrane at initial vitrectomy was a poor prognostic factor in final visual acuity (p = 0.02).
CONCLUSIONS
Endophthalmitis after pars plana vitrectomy showed very poor final visual acuity and better BCVA at presentation resulted in better final visual acuity. Poor visual acuity was observed in patients who had the internal limiting membrane removed at first vitrectomy.

Keyword

Endophthalmitis; Pars plana vitrectomy; Visual acuity

MeSH Terms

Cataract
Diabetes Mellitus
Endophthalmitis*
Escherichia coli
Humans
Membranes*
Retrospective Studies
Staphylococcus epidermidis
Visual Acuity
Vitrectomy*

Reference

References

1. Eifrig CW, Scott IU, Flynn HW Jr. . Endophthalmitis after pars plana vitrectomy: Incidence, causative organisms, and visual acuity outcomes. Am J Ophthalmol. 2004; 138:799–802.
Article
2. Govetto A, Virgili G, Menchini F. . A systematic review of en-dophthalmitis after microincisional versus 20-gauge vitrectomy. Ophthalmology. 2013; 120:2286–91.
Article
3. Cohen SM, Flynn HW Jr, Murray TG, Smiddy WE. Endophthalmitis after pars plana vitrectomy. The Postvitrectomy Endophthalmitis Study Group. Ophthalmology. 1995; 102:705–12.
4. Lee JW, Kim DJ, Shin JP, Kim SY. A case of endophthalmitis after 25-gauge transconjunctival sutureless vitrectomy. J Korean Ophthalmol Soc. 2007; 48:172–8.
5. Chung JH, Chang DJ, Lee WK. . A case of acute endoph-thalmitis after 23-gauge transconjunctival sutureless vitrectomy. J Korean Ophthalmol Soc. 2010; 51:899–903.
Article
6. Eifrig CW, Flynn HW Jr, Scott IU, Newton J. Acute-onset post-operative endophthalmitis: review of incidence and visual outcomes (1995-2001). Ophthalmic Surg Lasers. 2002; 33:373–8.
Article
7. Miller JJ, Scott IU, Flynn HW Jr. . Acute-onset endoph-thalmitis after cataract surgery (2000-2004): incidence, clinical set-tings, and visual acuity outcomes after treatment. Am J Ophthalmol. 2005; 139:983–7.
Article
8. Michels RG, Ryan SJ Jr. Results and complications of 100 consecutive cases of pars plana vitrectomy. Am J Ophthalmol. 1975; 80:24–9.
Article
9. Wu L, Berrocal MH, Arévalo JF. . Endophthalmitis after pars plana vitrectomy: results of the Pan American Collaborative Retina Study Group. Retina. 2011; 31:673–8.
10. Kim HW, Kim SY, Chung IY. . Emergence of Enterococcus species in the infectious microorganisms cultured from patients with endophthalmitis in South Korea. Infection. 2014; 42:113–8.
Article
11. Jung JY, Ko BY, Kim BY. Factors associated with a poor visual result in acute endophthalmitis after cataract surgery. J Korean Ophthalmol Soc. 2008; 49:1242–7.
Article
12. Hatano H. [Experimental Pseudomonas endophthalmitis in rabbits. Intracameral inoculation of two pseudomonal strains]. Nihon Ganka Gakkai Zasshi. 1982; 86:839–45.
13. Kunimoto DY, Kaiser RS. Wills Eye Retina Service. Incidence of endophthalmitis after 20- and 25-gauge vitrectomy. Ophthalmology. 2007; 114:2133–7.
Article
14. Wollensak G, Green WR. Remarkable case of early Aspergillus endophthalmitis. Aust N Z J Ophthalmol. 1999; 27:361–4.
Article
15. Wollensak G, Spoerl E, Grosse G, Wirbelauer C. Biomechanical significance of the human internal limiting lamina. Retina. 2006; 26:965–8.
Article
16. Stepien KE, Eaton AM, Jaffe GJ. . Increased incidence of sterile endophthalmitis after intravitreal triamcinolone acetonide in spring 2006. Retina. 2009; 29:207–13.
Article
17. Ahn SJ, Kim TW, Ahn J. . Associated factors and treatment outcome of presumed noninfectious endophthalmitis occurring after intravitreal triamcinolone acetonide injection. Graefes Arch Clin Exp Ophthalmol. 2013; 251:715–23.
Article
Full Text Links
  • JKOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr