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Methods: Retrospective study of 126 consecutive eyes that underwent VIT (82) or TAP (44) between 2005 and 2015. All eyes were stratified into a group according to their pre and postoperative visual acuity. Group 1 included patients with visual acuity of 20/40 or better, group 2 had a visual acuity ranging from 20/50 to 20/100, group 3 had a visual acuity <20/100- 20/400, group 4 had a visual acuity of <20/400-CF, and group 5 had a visual acuity of HM-LP. Outcome measures were post intervention visual acuity (VA) and complications.
Results: Mean preop VA was 20/2000 in VIT and 20/1800 in TAP (p=0.30), while postop VA was 20/160 in VIT and 20/125 in TAP (p=0.18). Preoperative vision was HM or LP in 87/126 eyes. Among those with poor preoperative vision of <20/400, postoperative vision was significantly better in the VIT group when compared to the TAP group (p=0.05). In eyes with good preoperative vision (20/400 or better), the mean postoperative vision was not significantly different between the VIT or TAP group (p=0.94). Final vision in all eyes was 20/40 or better in 25%, 20/100 or better in 56%, and only 11% had vision of HM or worse. Twelve eyes (9.5%) developed retinal detachment (RD), all in the VIT group, with 11/12 presenting with poor preoperative vision.
Conclusion: VIT or TAP has a similar visual outcome in patients with postoperative bacterial endophthalmitis that present with 20/400 or better vision. Sutureless vitrectomy (VIT) was found to be more beneficial than TAP in patients with worse than 20/400 initial vision. RD is more likely in the VIT group primarily due to poor presenting visual acuity.
Keywords: Endophthalmitis, vitrectomy (VIT), tap and inject (TAP)
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2. Driebe WT, Mandelbaum S, Forster RK. Pseudophakic endophthalmitis. Ophthalmology 1986;93:442-448.
3. Endophthalmitis Vitrectomy Study Group. Results of the Endophthalmitis Vitrectomy Study: a randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Arch Ophthalmol 1995;113:1479-96.
4. Gower E, Keay L, Stare D. Characteristics of endophthalmitis after cataract surgery in the United Sates Medicare population. Ophthalmology. 2015;122(8):1625-1632.
5. Hashemian H, Mirshahi R, Khodaparast M. Post-cataract surgery endophthalmitis: Brief literature review. J Curr Ophthalmol 2016;28(3): 101-105.
6. Kessel L, Flesner P, Andresen J. Antibiotic prevention of postcataract endophthalmitis: a systematic review and meta-analysis. Acta Ophthalmol 2015;93(4):303-17.
7. Lundström M., Friling E., Montan P. Risk factors for endophthalmitis after cataract surgery: predictors for causative organisms and visual outcomes. J Cataract Refract Surg. 2015;41:2410–2416.
8. Ng JQ, Morlet M, Pearman J. Management and outcomes of postoperative endophthalmitis since the Endophthalmitis Vitrectomy Study. Ophthalmology 2005;112(7):1199-206.
9. Puliafito CA, Baker AS, Haaf J. Infectious endophthalmitis. Ophthalmology 1982;89:921-929.
10. Wykoff C, Parrott MB, Flynn Jr. HW. Nosocomial acute-onset postoperative endophthalmitis at a University teaching hospital (2002-2009). Am J Ophthalmol 2010;150(3):392-398.