Kai Januschowski1,2, Karl Thomas Boden1, Peter Szurman1, Peter Stalmans3, Rudolf Siegel4, Núria Pérez Guerra1, Sören Leif Becker5, Annekatrin Rickmann1, Lukas Bisorca-Gassendorf6. 1. Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280, Sulzbach, Germany. 2. Centre for Ophthalmology, University Eye Hospital Tuebingen, Schleichstraße 12, 72076, Tuebingen, Germany. 3. Department of Ophthalmology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. 4. Industrial and Organizational Psychology, Saarland University, Campus A1.3, 66123, Saarbruecken, Germany. 5. Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Straße, Building 43, 66421, Homburg, Germany. 6. Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280, Sulzbach, Germany. lukas.bisorca-gassendorf@kksaar.de.
Abstract
PURPOSE: To show that an immediate vitrectomy with an intravitreal injection of antibiotics can be an effective approach for the treatment of acute endophthalmitis following intravitreal injections. METHODS: We reviewed all cases of clinical endophthalmitis caused by an intravitreal injection that were treated in our department between March 2012 and November 2019. Only patients that underwent a vitrectomy within 6 h after presentation to the clinic and with a documented visual acuity shortly before the causative event were included. Baseline best-corrected visual acuity (BCVA) before the causative event was compared to BCVA measured within a follow-up period of 8 months (up to 14 months). RESULTS: In total, 30 eyes of 30 patients were included. The BCVA before the intraocular infection was a mean value of 0.55 logMAR, and the BCVA on the day of the endophthalmitis decreased significantly to 1.66 logMAR. Within 2 months following the pars plana vitrectomy (PPV), the mean BCVA improved to 0.83 logMAR. Eight months following PPV (mean value, 8.20 months; SD, 3.59 months), the mean BCVA was 0.63 logMAR. In the last follow-up interval most of the eyes recovered, and the BCVA did not differ significantly from baseline. Two eyes underwent further pars plana surgery during the follow-up period. No enucleation was required. CONCLUSION: In this study, we have shown that an immediate vitrectomy with subsequent intravitreal injection of antibiotics is an effective option for treating post-injection endophthalmitis and frequently results in recovery of vision; thus, it should be performed as early as possible, where available.
PURPOSE: To show that an immediate vitrectomy with an intravitreal injection of antibiotics can be an effective approach for the treatment of acute endophthalmitis following intravitreal injections. METHODS: We reviewed all cases of clinical endophthalmitis caused by an intravitreal injection that were treated in our department between March 2012 and November 2019. Only patients that underwent a vitrectomy within 6 h after presentation to the clinic and with a documented visual acuity shortly before the causative event were included. Baseline best-corrected visual acuity (BCVA) before the causative event was compared to BCVA measured within a follow-up period of 8 months (up to 14 months). RESULTS: In total, 30 eyes of 30 patients were included. The BCVA before the intraocular infection was a mean value of 0.55 logMAR, and the BCVA on the day of the endophthalmitis decreased significantly to 1.66 logMAR. Within 2 months following the pars plana vitrectomy (PPV), the mean BCVA improved to 0.83 logMAR. Eight months following PPV (mean value, 8.20 months; SD, 3.59 months), the mean BCVA was 0.63 logMAR. In the last follow-up interval most of the eyes recovered, and the BCVA did not differ significantly from baseline. Two eyes underwent further pars plana surgery during the follow-up period. No enucleation was required. CONCLUSION: In this study, we have shown that an immediate vitrectomy with subsequent intravitreal injection of antibiotics is an effective option for treating post-injection endophthalmitis and frequently results in recovery of vision; thus, it should be performed as early as possible, where available.
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
Authors: Cindy X Zheng; Marlene R Moster; M Ali Khan; Allen Chiang; Sunir J Garg; Yang Dai; Michael Waisbourd Journal: Retina Date: 2017-06 Impact factor: 4.256