Endophthalmitis after Pars Plana Vitrectomy
| Autor: | Christine R. Gonzales, Jean-Louis Bourges, Scott C N Oliver, Steven D. Schwartz, Sumit P Shah, Allen Y.H. Hu, Adit Gupta |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Pars plana
medicine.medical_specialty business.industry medicine.medical_treatment Incidence (epidemiology) Vitrectomy Perioperative medicine.disease Single Center Surgery Ophthalmology symbols.namesake medicine.anatomical_structure Endophthalmitis Inclusion and exclusion criteria medicine symbols business Fisher's exact test |
| Zdroj: | Ophthalmology. 116:1360-1365 |
| ISSN: | 0161-6420 |
| DOI: | 10.1016/j.ophtha.2009.01.045 |
| Popis: | Objective Recent retrospective analyses have suggested that postoperative endophthalmitis may be more frequent with 25- than 20-gauge pars plana vitrectomy (PPV). Because the infection risk may depend on the suturing status of the sclerotomy, and the perioperative anti-infection protocol, we compared the incidence rate of endophthalmitis after sutureless 25-gauge versus sutured 20-gauge PPV on a large cohort of patients operated with a standardized perioperative anti-infection protocol. Design Retrospective comparative case series. Participants Consecutive patients who underwent 20- or 25-gauge PPVs at a single center over a multi-year period. Methods We analyzed 3597 consecutive PPVs. Patients with a pre-PPV diagnosis of endophthalmitis, PPVs performed for implantation of drug delivery devices, or 25-gauge PPVs with all sclerotomies sutured closed were excluded. Patients with ≥1 week of follow-up were divided into 2 study groups by sclerotomy status at the end of surgery: the 20-gauge group had 3 sutured 20-gauge sclerotomies, and the 25-gauge group had ≥1 unsutured 25-gauge sclerotomy. Endophthalmitis was defined by clinical criteria independent of microbiological results. Main Outcome Measures The incidence of endophthalmitis was compared between 25- versus 20-gauge groups. Results Of 3372 PPV surgeries meeting inclusion and exclusion criteria, 1948 and 1424 surgeries were 20- and 25-gauge PPVs, respectively. Average age (± standard deviation) of patients was 54.6 (± 22.6) and 64.4 (± 16.5) years in the 20- and 25-gauge PPV groups, respectively ( P P = 0.69). Endophthalmitis was observed in 1 patient (0.07%; 95% confidence interval, 0%–0.21%) from the 25-gauge group and none in the 20-gauge group ( P = 0.42; Fisher exact test, 2-tailed). The use of air/gas endotamponade ( P P Conclusions The incidence of endophthalmitis was low in both groups. We were unable to show a significant difference in the incidence of endophthalmitis between sutureless 25-gauge and sutured 20-gauge PPV, and conclude that a careful perioperative anti-infection protocol may reduce 25-gauge PPV endophthalmitis risk to that of 20-gauge PPV. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references. |
| Databáze: | OpenAIRE |
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