Retina (Philadelphia, Pa.) · 2026
ENDOPHTHALMITIS INCIDENCE AFTER VITRECTOMY: A Systematic Review and Meta-Analysis of Risk Factors and Prevention Strategy.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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McGrath Robert, Mulcahy Liam, Al Abri Abdulrahman, Whitlow Shane, Brennan Nicholas, Connell Paul
Аннотация
PURPOSE: Consensus is lacking on best practice to minimize endophthalmitis rates after vitrectomy. This review examines all available literature to determine the incidence of postvitrectomy endophthalmitis and associated risk-reduction strategies.
METHODS: A comprehensive literature search was performed for endophthalmitis incidence after vitrectomy. Meta-analysis was performed comparing risk factors for endophthalmitis: instrument gauge, prophylactic antibiotics, phacovitrectomy, and intraocular tamponade.
RESULTS: We identified 69 studies which reported 2,781 cases of endophthalmitis after 1,979,160 vitrectomies (0.14%). Meta-analysis found that smaller-gauge vitrectomy had a nonsignificantly higher risk of endophthalmitis compared with 20-gauge surgery (OR 2.09, 95% CI 0.88-5.0). Endophthalmitis rates were significantly higher with 25-gauge compared with 23-gauge instruments (OR 2.03, 95% CI 1.05-3.92). Prophylactic subconjunctival antibiotic use did not decrease the risk of endophthalmitis compared with topical antibiotics (OR 0.77, 95% CI 0.36-1.64). Phaco-vitrectomy did not increase the endophthalmitis risk (OR 1.17, 95% CI 0.81-1.70). The use of intraocular tamponade other than fluid was associated with significantly lower rates of endophthalmitis (OR 0.15, 95% CI 0.09-0.27).
CONCLUSION: The incidence of endophthalmitis was higher than in previous reviews. Nonfluid intraocular tamponade significantly reduced the incidence of endophthalmitis but subconjunctival antibiotics did not. Small-gauge vitrectomy and phacovitrectomy were not associated with significantly higher rates of endophthalmitis.
METHODS: A comprehensive literature search was performed for endophthalmitis incidence after vitrectomy. Meta-analysis was performed comparing risk factors for endophthalmitis: instrument gauge, prophylactic antibiotics, phacovitrectomy, and intraocular tamponade.
RESULTS: We identified 69 studies which reported 2,781 cases of endophthalmitis after 1,979,160 vitrectomies (0.14%). Meta-analysis found that smaller-gauge vitrectomy had a nonsignificantly higher risk of endophthalmitis compared with 20-gauge surgery (OR 2.09, 95% CI 0.88-5.0). Endophthalmitis rates were significantly higher with 25-gauge compared with 23-gauge instruments (OR 2.03, 95% CI 1.05-3.92). Prophylactic subconjunctival antibiotic use did not decrease the risk of endophthalmitis compared with topical antibiotics (OR 0.77, 95% CI 0.36-1.64). Phaco-vitrectomy did not increase the endophthalmitis risk (OR 1.17, 95% CI 0.81-1.70). The use of intraocular tamponade other than fluid was associated with significantly lower rates of endophthalmitis (OR 0.15, 95% CI 0.09-0.27).
CONCLUSION: The incidence of endophthalmitis was higher than in previous reviews. Nonfluid intraocular tamponade significantly reduced the incidence of endophthalmitis but subconjunctival antibiotics did not. Small-gauge vitrectomy and phacovitrectomy were not associated with significantly higher rates of endophthalmitis.