Clinical analysis of endophthalmitis after minimally invasive vitrectomy
Journal Title: Eye Science (Yanke Xuebao) - Year 2024, Vol 39, Issue 3
Abstract
[Objective:] To analyze risk factors for endophthalmitis occurred after 23G/25G minimally invasive vitrectomy. [Methods:] Retrospective analysis of the clinical characteristics of patients with endophthalmitis (except patients with open eye trauma) after minimally invasive vitrectomy in General Hospital of Central Theater Command (Wuhan, 430064) from June 2014 to May 2023. [Results:] This study included 8, 955 patients, of which 11 cases occurred endophthalmitis after minimally invasive vitrectomy, with an incidence rate of 0.12%. The average age was (60.8±7.6) years, and 5 patients (45.4%) were complicated with diabetes; The composition of primary eye diseases: 7 cases (63.6%) of macular disease, 2 cases (18.2%) of vitreous hemorrhage secondary to proliferative diabetic retinopathy and 1 case (9.1%) vitreous hemorrhage secondary to retinal fissure, 1 case (9.1%) of retinal detachment; During the operation, 3 cases (27.3%) underwent combined cataract surgery; After the operation, 8 cases (72.7%) were filled with sterile air in the vitreous cavity of affected eye, the other 3 cases (27.3%) were filled with equilibrium liquid, and sclera puncture incision was not sutured in all patients; 3 cases (27.3%) had low intraocular pressure after operation. The time for postoperative endophthalmitis to occur after operation was 2.8±1.1day. 11 patients had poor inflammation control after local and systemic anti-inflammatory treatments, and all underwent vitrectomy combined with intraoperative injection of vancomycin solution. Among them, 9 patients were filled with silicone oil in the vitreous cavity after the surgery. After the operation, all the endophthalmitis were controlled and final corrected visual acuity of 10 patients improved. [Conclusions] Minimally invasive vitrectomy and suture-free scleral incision may be a potential way for pathogenic microorganisms to invade the eye and cause endophthalmitis. Particular attention should be paid to the ‘Vitreous Wick Syndrome’ at the scleral incision caused by incomplete vitrectomy in macular surgery, which may be one of the risk factors for postoperative endophthalmitis.
Authors and Affiliations
Ying YAN, Nian XIANG, Qiaonuo WEI, Juan YU, Xiao CHEN
Keywords
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- EP ID EP764733
- DOI 10.12419/24031902
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