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A prospective and nationwide study investigating endophthalmitis following pars plana vitrectomy: clinical presentation, microbiology, management and outcome
  1. Jonathan C Park1,
  2. Balasubramanian Ramasamy2,
  3. Stephen Shaw3,
  4. Roland H L Ling1,
  5. Som Prasad2
  1. 1West of England Eye Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK
  2. 2Wirral University Teaching Hospital NHS Foundation Trust, Arrowe Park Hospital, Wirral, UK
  3. 3School of Computing and Mathematics, Plymouth University, Plymouth, Devon, UK
  1. Correspondence to Jonathan C Park, West of England Eye Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon EX2 5DW, UK; jonathanpark{at}nhs.net

Abstract

Background/Aims This is the first prospective and nationwide study aiming to provide epidemiological data relating to presentation, microbiology, management and outcome of endophthalmitis following vitrectomy.

Methods Two years of prospective and nationwide surveillance for cases of presumed infectious endophthalmitis within 6 weeks of pars plana vitrectomy was completed. The study obtained case reports via the established British Ophthalmological Surveillance Unit (BOSU) system.

Results Thirty-seven cases were reported and 28 met the diagnostic criteria for presumed infectious endophthalmitis following vitrectomy. Mean age was 61 years and 67% were male. Nineteen cases were 23/25 gauge and 9 cases were 20 gauge. Mean time from surgery to endophthalmitis was 5 days. Blurred vision (85.2%), pain (77.8%) and a hypopyon (77.8%) were the commonest presenting symptoms and signs. Seventeen cases (60.7%) had a positive culture. Culture-positive endophthalmitis, relative to culture-negative endophthalmitis, was no different with respect to time to presentation, symptoms, signs or outcome. Outcome was poor, with 29.6% of eyes being eviscerated or having no perception of light or perception of light.

Conclusions This study helps surgeons promptly identify cases of endophthalmitis following vitrectomy and informs them about the various management options currently used and the likely outcome of this devastating complication.

  • Epidemiology
  • Infection
  • Microbiology
  • Retina
  • Treatment Surgery

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