Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2012
23-gauge transconjunctival sutureless vitrectomy in treatment of post-operative endophthalmitis.
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Almanjoumi Ahmed M, Combey Aurélie, Romanet Jean Paul, Chiquet Christophe
Аннотация
PURPOSE: To report the safety and efficacy of 23-gauge (23-G) transconjunctival vitrectomy (TSV) in the surgical management of postoperative endophthalmitis.
MATERIALS AND METHODS: Ten consecutive patients underwent a 23-G TSV in 2008-2010 after cataract surgery (n = 5) or filtrating surgery (n = 5), and were prospectively studied with a minimum follow-up of 6 months. TSV was performed within a median delay of 1 day after the diagnosis, after one or two injections of intravitreal antibiotics (vancomycin, ceftazidime). Conventional cultures (brain heart infusion media) and/or panbacterial PCR were performed on aqueous humor and/or vitreous samples.
RESULTS: Initial visual acuity was less than or equal to hand motion in all cases, and clinical findings included hypopyon (80%), pupillary fibrin membrane (80%), and dense vitreitis (4+, 100%). The bacteria identified were Gram-positive cocci in 60% of the cases (coagulase-negative staphylococci, 20%; streptococcus, 40%) and Gram-negative bacilli in 10% (moraxella lacunata). All patients had central and peripheral vitrectomy (mean duration, 58.6 ± 16 min). No intraoperative complications were noted. Two patients developed retinal detachment postoperatively and were reoperated. The final visual vision was 20/400 for two patients and 20/50 or better for the other patients.
CONCLUSION: 23-G TSV allows the surgeon to meet the same objectives as the 20-G technique for the treatment of endophthalmitis.
MATERIALS AND METHODS: Ten consecutive patients underwent a 23-G TSV in 2008-2010 after cataract surgery (n = 5) or filtrating surgery (n = 5), and were prospectively studied with a minimum follow-up of 6 months. TSV was performed within a median delay of 1 day after the diagnosis, after one or two injections of intravitreal antibiotics (vancomycin, ceftazidime). Conventional cultures (brain heart infusion media) and/or panbacterial PCR were performed on aqueous humor and/or vitreous samples.
RESULTS: Initial visual acuity was less than or equal to hand motion in all cases, and clinical findings included hypopyon (80%), pupillary fibrin membrane (80%), and dense vitreitis (4+, 100%). The bacteria identified were Gram-positive cocci in 60% of the cases (coagulase-negative staphylococci, 20%; streptococcus, 40%) and Gram-negative bacilli in 10% (moraxella lacunata). All patients had central and peripheral vitrectomy (mean duration, 58.6 ± 16 min). No intraoperative complications were noted. Two patients developed retinal detachment postoperatively and were reoperated. The final visual vision was 20/400 for two patients and 20/50 or better for the other patients.
CONCLUSION: 23-G TSV allows the surgeon to meet the same objectives as the 20-G technique for the treatment of endophthalmitis.
Предметные рубрики MeSH
AgedAged, 80 and overAnti-Bacterial AgentsAqueous HumorBacteriaCataract ExtractionConjunctivaDNA, BacterialEndophthalmitisEye Infections, BacterialFemaleFollow-Up StudiesHumansMaleMicrosurgeryMiddle AgedPolymerase Chain ReactionPostoperative ComplicationsProspective StudiesSuture TechniquesTrabeculectomyTreatment OutcomeVisual AcuityVitrectomyVitreous Body