Postoperative Bacterial Endophthalmitis: Tap/Inject versus Sutureless Vitrectomy
Main Article Content
Abstract
Purpose: To compare sutureless vitrectomy (VIT) versus vitreous tap/injection (TAP) in eyes with postoperative bacterial endophthalmitis.
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)
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)
Article Details
How to Cite
MASON, Lauren B. et al.
Postoperative Bacterial Endophthalmitis: Tap/Inject versus Sutureless Vitrectomy.
Medical Research Archives, [S.l.], v. 5, n. 2, feb. 2017.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/999>. Date accessed: 17 nov. 2024.
Keywords
Endophthalmitis, vitrectomy (VIT), tap and inject (TAP)
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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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.
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.