Sukhum Silpa-Archa1, Kwanchanoke Kumsiang2, Janine M Preble3. 1. Faculty of Medicine, Department of Ophthalmology, College of Medicine, Rajavithi Hospital, Rangsit University, 2 Phayathai Road, Ratchathewi District, Bangkok, 10400, Thailand. sukhumsilp@gmail.com. 2. Faculty of Medicine, Department of Ophthalmology, College of Medicine, Rajavithi Hospital, Rangsit University, 2 Phayathai Road, Ratchathewi District, Bangkok, 10400, Thailand. 3. Department of Ophthalmology, Kresge Eye Institute, School of Medicine, Wayne State University, 4717 St. Antoine, Detroit, MI, 48201, USA.
Abstract
BACKGROUND: To describe the incidence, clinical characteristics, and treatment outcomes of endophthalmitis after pars plana vitrectomy (PPV) with recycled single-use devices. The recommended sterilization process as well as safety measures are discussed. METHODS: Medical charts of patients who developed endophthalmitis after PPV were retrospectively reviewed and reported in a descriptive manner. Cases undergoing PPV for preexisting endophthalmitis or open globe injury were excluded. Data collection included patient demographics, operative details, ocular findings, microbiological profiles, treatment modalities, and visual outcomes. RESULTS: Over the past thirteen years, a total of 12,989 pars plana vitrectomy operations were included. In total, 13 eyes of 13 cases (0.10%) experienced endophthalmitis after vitrectomy. These occurred in 3 cases (0.11%) using 20-gauge vitrectomy compared to 8 cases (0.09%) using 23-gauge vitrectomy and 2 cases (0.18%) using 25-gauge vitrectomy. There were no statistically significant differences between the 20-gauge and microincisional vitrectomy surgery (MIVS) group (P = 0.64), and the 23- and 25-gauge approach (P = 0.34). Causative pathogens were positive by culture in 5 cases (45%): 3 g-positive cases, 1 g-negative case, and 1 fungus case. CONCLUSIONS: The rate of endophthalmitis in patients who underwent 23-gauge PPV was comparable to those who underwent 25-gauge PPV. With our standardized protocol for instrument sterilization, endophthalmitis rates in those undergoing PPV using recycled single-use instruments were within the range of previously published results in which vitrectomy tools were disposed of after one use.
BACKGROUND: To describe the incidence, clinical characteristics, and treatment outcomes of endophthalmitis after pars plana vitrectomy (PPV) with recycled single-use devices. The recommended sterilization process as well as safety measures are discussed. METHODS: Medical charts of patients who developed endophthalmitis after PPV were retrospectively reviewed and reported in a descriptive manner. Cases undergoing PPV for preexisting endophthalmitis or open globe injury were excluded. Data collection included patient demographics, operative details, ocular findings, microbiological profiles, treatment modalities, and visual outcomes. RESULTS: Over the past thirteen years, a total of 12,989 pars plana vitrectomy operations were included. In total, 13 eyes of 13 cases (0.10%) experienced endophthalmitis after vitrectomy. These occurred in 3 cases (0.11%) using 20-gauge vitrectomy compared to 8 cases (0.09%) using 23-gauge vitrectomy and 2 cases (0.18%) using 25-gauge vitrectomy. There were no statistically significant differences between the 20-gauge and microincisional vitrectomy surgery (MIVS) group (P = 0.64), and the 23- and 25-gauge approach (P = 0.34). Causative pathogens were positive by culture in 5 cases (45%): 3 g-positive cases, 1 g-negative case, and 1 fungus case. CONCLUSIONS: The rate of endophthalmitis in patients who underwent 23-gauge PPV was comparable to those who underwent 25-gauge PPV. With our standardized protocol for instrument sterilization, endophthalmitis rates in those undergoing PPV using recycled single-use instruments were within the range of previously published results in which vitrectomy tools were disposed of after one use.
Entities:
Keywords:
23-gauge; 25-gauge; Endophthalmitis; Ethylene oxide; Hydrogen peroxide; Pars plana vitrectomy; Recycled; Single-use devices
Authors: Hasan M Bahrani; Ahad A Fazelat; Mathis Thomas; Tatsuo Hirose; Arnold J Kroll; Peter L Lou; Edward A Ryan Journal: Semin Ophthalmol Date: 2010 Sep-Nov Impact factor: 1.975
Authors: Stephanie J Weiss; Murtaza K Adam; Xinxiao Gao; Anthony Obeid; Arunan Sivalingam; Mitchell S Fineman; Joseph I Maguire; Sunir J Garg; Julia Haller; David H Fischer; Jason Hsu Journal: Retina Date: 2018-09 Impact factor: 4.256
Authors: Emily W Gower; Lisa J Keay; Dianne E Stare; Pallavi Arora; Sandra D Cassard; Ashley Behrens; James M Tielsch; Oliver D Schein Journal: Ophthalmology Date: 2015-06-02 Impact factor: 12.079