Chia-Ming Hsu1, Shih-Chou Chen1, Tsung-Tien Wu2, Shwu-Jiuan Sheu3. 1. Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC. 2. Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC. Electronic address: ttwu@vghks.gov.tw. 3. Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
Abstract
BACKGROUND: To report our 3-year experience of 23-gauge transconjunctival sutureless vitrectomy (TSV) for acute postoperative endophthalmitis at a tertiary referral center in southern Taiwan. METHODS: This retrospective chart review study included 19 patients with acute postoperative endophthalmitis who underwent 23-gauge TSV from January 2011 to January 2015 at Kaohsiung Veterans General Hospital, Taiwan. Bacterial and fungal cultures from aqueous samples, vitreous samples, or both were performed. RESULTS: Nineteen patients (12 male; 7 female) were included. The mean age was 72.4 ± 8.29 years. Acute postoperative endophthalmitis was noted in 18 patients after cataract surgery and in 1 patient after 23-gauge vitrectomy for a rhegmatogenous retinal detachment. Upon presentation, visual acuity was less than hand movement for 80% of the patients. Chief complaints included blurred vision (19 patients, 100%), followed by pain (10 patients, 52.6%) and red eye (4 patients, 21%). All patients were administered an intravitreal injection (IVI) of antibiotics and 23-gauge TSV, and the average number of IVIs was 2.68 ± 1.73 (1-9 IVIs). The interval between their initial eye symptoms and vitrectomy was 4.11 ± 4.73 days (0-2 days), and the interval between diagnosis with endophthalmitis and a vitrectomy was 1.11 ± 1.52 days (0-6 days). The final visual acuity was no light perception for 1 patient (5.3%), between 6/60 and 6/12 for 8 patients (42.1%), and 6/12 or better for 9 patients (47.4%). No retinal detachment or hypotony was noted postoperatively in any case. CONCLUSION: 23-gauge vitrectomy is safe and effective for the management of acute postoperative endophthalmitis. Early diagnosis and treatment with 23-gauge vitrectomy may provide a good visual outcome.
BACKGROUND: To report our 3-year experience of 23-gauge transconjunctival sutureless vitrectomy (TSV) for acute postoperative endophthalmitis at a tertiary referral center in southern Taiwan. METHODS: This retrospective chart review study included 19 patients with acute postoperative endophthalmitis who underwent 23-gauge TSV from January 2011 to January 2015 at Kaohsiung Veterans General Hospital, Taiwan. Bacterial and fungal cultures from aqueous samples, vitreous samples, or both were performed. RESULTS: Nineteen patients (12 male; 7 female) were included. The mean age was 72.4 ± 8.29 years. Acute postoperative endophthalmitis was noted in 18 patients after cataract surgery and in 1 patient after 23-gauge vitrectomy for a rhegmatogenous retinal detachment. Upon presentation, visual acuity was less than hand movement for 80% of the patients. Chief complaints included blurred vision (19 patients, 100%), followed by pain (10 patients, 52.6%) and red eye (4 patients, 21%). All patients were administered an intravitreal injection (IVI) of antibiotics and 23-gauge TSV, and the average number of IVIs was 2.68 ± 1.73 (1-9 IVIs). The interval between their initial eye symptoms and vitrectomy was 4.11 ± 4.73 days (0-2 days), and the interval between diagnosis with endophthalmitis and a vitrectomy was 1.11 ± 1.52 days (0-6 days). The final visual acuity was no light perception for 1 patient (5.3%), between 6/60 and 6/12 for 8 patients (42.1%), and 6/12 or better for 9 patients (47.4%). No retinal detachment or hypotony was noted postoperatively in any case. CONCLUSION: 23-gauge vitrectomy is safe and effective for the management of acute postoperative endophthalmitis. Early diagnosis and treatment with 23-gauge vitrectomy may provide a good visual outcome.