International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis

Autor: Mohamed K. Soliman, Giampoalo Gini, Ferenc Kuhn, Mariano Iros, Barbara Parolini, Sengul Ozdek, Zofia Michalewska, Silvia Bopp, Ron A. Adelman, Ahmed B. Sallam, Agnieszka Kardaszewska, Alain Nazaire M’Bongo Zindamoyen, Alay Banker, Andrii Serhiienko, Angela Loo, Angelina Meireles, Bahri Aydin, Britta Luebke, Cüneyt Özmen, Dominik Odrobina, Enrico Bertelli, Erkan Unsal, Fong Kenneth, Frank Becquet, Frederic Hamon, Giacomo Pellegrini, Gian Marco Tosi, Giuseppe Donvito, Hussain Khaqan, Idriss Badat, Ivan Fiser, Janusz Michalewski, Jean Francois Le Rouic, Jerzy Nawrocki, Jesus Zarallo-Gallardo, Jugn Ho Lee, Karolina Boninska, Katarzyna Nowomiejska, Krzysztof Dziegielewski, Luis Arrevola, Lyubomyr Lytvynchuk, Maha Elshafei, Malgorzata Pietras-Trzpiel, Mariano Irós, Martin Detjen, Matias Iglicki, Matteo Badino, Meireles Angelina, Mikhail Gavura, Murat Hasanreisoğlu, Mustafa Karadaş, Narciso Atienza, Nur Acar, Ogugua Okonkwo, Peter Miesbauer, Pietras-Trzpiel Malgorzata, Raul Velez-Montoya, Rejdak Robert, Rino Frisina, Rita Soyeur, Robert Rejdak, Roberta Giannini, Sangeet Mittal, Shohista Saidkasimova, Shuaib Abdulsalam, Slawomir Cisiecki, Stepan Rusnak, Stephen Teoh, Susana Teixeira, Tugrul Altan, Wolfgang Schrader, Zia Kapran, Zeynep Aktas, Zsuzsanna Szijártó
Rok vydání: 2019
Předmět:
Zdroj: Ophthalmology Retina. 3:461-467
ISSN: 2468-6530
Popis: Purpose To study the practice patterns for the management of acute postoperative and postinjection endophthalmitis. Design Retrospective, interventional, nonrandomized, multicenter study. Participants Data on 237 eyes diagnosed with acute endophthalmitis occurring after intraocular surgery or procedures provided by 57 retina specialists from 28 countries. Main Outcome Measures Rates of pars plana vitrectomy (PPV), repeat intravitreal injection, and adjunctive therapeutic regimens (local and systemic antibiotics and steroids). Results Of 237 analyzed eyes, acute endophthalmitis secondary to cataract surgery or secondary lens implantation represented 64.6% of cases (153 eyes), whereas the remaining were secondary to intravitreal injections (35 eyes [14.8%]), PPV (29 eyes [12.2%]), and other intraocular surgeries (20 eyes [8.4%]). All eyes received intravitreal antibiotics on the same day of diagnosis. Overall, early PPV was used within the first week of presentation in 176 eyes (74.3%). There was no statistical difference in the proportion of eyes requiring a second intravitreal injection of antibiotics whether the eye was managed primarily with intravitreal antibiotics alone versus early PPV plus intravitreal antibiotics (29.5% [18 eyes] vs. 25.0% [44 eyes], respectively). Adjunctive therapies in the form of intravitreal steroids, systemic steroids, and systemic antibiotics were used in 25.3%, 21.9%, and 66.6% of eyes, respectively. The absence of disc or macular view and absence of endophthalmitis after cataract surgery were associated with an increased likelihood for early PPV (odds ratios 4.1 and 5.1, respectively). Conclusions Pars plana vitrectomy was frequently performed regardless of the presenting vision in eyes with endophthalmitis after cataract surgery and intravitreal injections. Increased vitreous opacification was associated with a higher probability for performing PPV.
Databáze: OpenAIRE