Incidence, microbiology, and outcomes of endophthalmitis after 111,876 pars plana vitrectomies at a single, tertiary eye care hospital

Autor: Muna Bhende, Rajiv Raman, Mukesh Jain, Pratik K Shah, Tarun Sharma, Lingam Gopal, Pramod S Bhende, Sangeetha Srinivasan, Malathi Jambulingam, Sankara Nethralaya Vitreoretinal Study Group (SNVR-Study Group)
Rok vydání: 2017
Předmět:
0301 basic medicine
Male
Visual acuity
Cardiovascular Procedures
medicine.medical_treatment
Visual Acuity
lcsh:Medicine
Vitrectomy
Vascular Surgery
Eye Infections
Bacterial
Tertiary Care Centers
0302 clinical medicine
Endophthalmitis
Postoperative Complications
Risk Factors
Antibiotics
Medicine and Health Sciences
lcsh:Science
Multidisciplinary
Antimicrobials
Incidence (epidemiology)
Incidence
Ophthalmic Procedures
Drugs
Cataract Surgery
Middle Aged
Prognosis
medicine.anatomical_structure
Female
Pars Plana Vitrectomy
medicine.symptom
Anatomy
Research Article
Pars plana
medicine.medical_specialty
India
Surgical and Invasive Medical Procedures
Eye care
Microbiology
03 medical and health sciences
Ocular System
Microbial Control
medicine
Humans
Minimally Invasive Surgical Procedures
Surgical Wound Infection
Lost to follow-up
Gram Negative Bacteria
Pharmacology
business.industry
lcsh:R
Biology and Life Sciences
Bacteriology
Eye infection
medicine.disease
Surgery
030104 developmental biology
030221 ophthalmology & optometry
Eyes
lcsh:Q
business
Head
Zdroj: PLoS ONE
PLoS ONE, Vol 13, Iss 1, p e0191173 (2018)
ISSN: 1932-6203
Popis: PURPOSE To describe the incidence, risk factors, clinical presentation, causative organisms, and outcomes in patients with endophthalmitis following pars plana vitrectomy (20G and minimally invasive vitrectomy surgery (MIVS). METHODS Of 111,876 vitrectomies (70,585 20-G 41,291 MIVS) performed, 45 cases developed acute-onset, postoperative endophthalmitis. RESULTS The rate of culture positive and culture negative endophthalmitis was 0.021% (2.1/10,000 surgeries) and 0.019% (1.9/10,000 surgeries) overall, 0.031% (3.1/10,000 surgeries) and 0.025% (2.5/10,000 surgeries) in 20G, and 0.005% (0.5/10,000 surgeries) and 0.007% (0.7/10,000 surgeries) in the MIVS group respectively. Potential predisposing factors were as follows: diabetes, 46.7%; vitrectomy for vascular retinopathies, 44.4%; and vitrectomy combined with anterior segment surgeries, 35.5%. The culture proven rates were 53.3% overall, 55.0% for 20G and 40.0% for MIVS. The most common organism was Pseudomonas aeruginosa for 20G. Klebsiella and Staphylococcus aureus were isolated in the two culture positive cases in MIVS group. The follow-up period for the patients with endophthalmitis was 586.14 ± 825.15 days. Seven were lost to follow up beyond one week. Of the remaining 38, 13 (34.2%) cases had a favorable visual outcome (i.e., best-corrected visual acuity [BCVA] > 5/200) and 24 (63.2%) had unfavorable visual outcome (BCVA < 5/200). Group with culture test results negative had significantly better outcomes (P < 0.05) as compared to those with positive. CONCLUSIONS MIVS does not increase the risk of endophthalmitis. Outcomes are poor despite appropriate treatment, particularly in cases with culture results positive.
Databáze: OpenAIRE
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