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Occurrence and risk factors for retinal detachment after pars plana vitrectomy in acute postcataract bacterial endophthalmitis
  1. Christophe Chiquet1,2,
  2. Florent Aptel1,2,
  3. Aurélie Combey-de Lambert1,2,
  4. Alain M Bron3,
  5. Nelly Campolmi4,
  6. Karine Palombi1,2,
  7. Gilles Thuret4,
  8. Frédéric Rouberol5,
  9. Pierre-Loïc Cornut5,
  10. Catherine Creuzot-Garcher3
  11. On behalf of the FRIENDS (French Institutional Endophthalmitis Study) group
    1. 1Grenoble Alpes University, Grenoble, France
    2. 2Department of Ophthalmology, University Hospital, Grenoble, France
    3. 3Department of Ophthalmology, University Hospital, Dijon, France
    4. 4Department of Ophthalmology, University Hospital, Saint-Etienne, France
    5. 5Department of Ophthalmology, Edouard Herriot University Hospital, University of Lyon I, Lyon, France
    1. Correspondence to Professor Christophe Chiquet, Department of Ophthalmology, University Hospital, BP 217, Grenoble 38043, France; cchiquet{at}chu-grenoble.fr

    Abstract

    Background/aims To report the incidence, risk factors and prognosis of retinal detachment (RD) in patients who had vitrectomy for acute bacterial endophthalmitis after cataract surgery.

    Methods 123 patients with acute postcataract endophthalmitis, consecutively treated with pars plana vitrectomy (PPV) were included by the French Institutional Endophthalmitis Study group, in a prospective multicentre cohort study. Risk factors of RD were analysed using logistic regression.

    Results At the 6-month follow-up, the rate of post-PPV RD was 13% (n=16). The risk factors of post-PPV RD were diabetes (OR=4.7 (1.4–15.4), p=0.01) and visualisation of retinal vasculitis on the posterior pole (OR=3.8 (1.1–13.9), p=0.03) at the time of PPV. Postoperative RD occurred in 56% (n=9) of cases in the first month, in 31% (n=5) in the second month and in 6% (n=1) in the third month, with a mean delay of 47±71 days after PPV. The macula was detached in 12 cases (75%) and proliferative vitreoretinopathy grade C was present in seven cases. Final successful reattachment of the retina was obtained in 60% (n=9/15) of cases, with one (7/9) or two surgeries (2/9). Final visual acuity after surgical repair was ≥20/40 in 19% of cases, compared with 43% in patients without RD (p=0.05).

    Conclusions RD is a major and severe complication of PPV performed in patients with acute postcataract endophthalmitis. Retinal vasculitis is a major risk factor of RD after PPV. Anatomical and functional outcome remain poor.

    • Infection
    • Inflammation
    • Treatment Surgery
    • Retina
    • Microbiology

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