First Author: P.Gouveia PORTUGAL
Co Author(s): C. Mendonca M. Sousa Falcao P. Alves Faria F. Falcao Reis A. Rocha Sousa
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To evaluate predictors of visual outcome in a series of patients treated for acute postoperative endophthalmitis (PE) and analyze the role of therapeutic vitrectomy (TV).
Retrospective study conducted at Hospital São João, Porto, Portugal, a tertiary health-care centre.
This series included all patients clinically diagnosed with acute PE from February 2008 through May 2016 at the Ophthalmology Department of Hospital São João (Porto, Portugal). All patients were treated with intravitreal antibiotics. Following observation by a retina specialist, patients underwent TV or continued conservative treatment. Visual acuity (VA) was assessed at the moment of diagnosis and the best VA after treatment was noted. Primary outcomes were best VA after treatment and variation of VA.
Sixty-one patients were included in our study. Comorbidities were statistically more frequent in the group of patients who underwent TV (42.4% vs 17.9%) and median of VA after treatment was worse in this group (2.1 LogMAR vs 0.5 LogMAR). Good VA, defined as ≤ 0.3 LogMAR, was reached only by 13 of 49 patients (26.5%). Presenting VA and undergoing a TV presented statistically significant differences in this analysis. On simple linear regression, we found that higher age, worse VA at diagnosis and needing a TV were significantly associated to worse VA after treatment; and that longer interval between surgery and the onset of symptoms as well as time elapsed from diagnosis until TV are significantly associated with shorter variation of VA. Performing a TV in the first 24h following diagnosis presents a greater variation of VA than performing it after this time. After the first 24h, submitting the patient to TV seems to result in progressively worse visual outcomes.
Our findings are consistent with previous ones. TV should be performed considering the overall clinical course and each patient’s characteristics. Our results suggest, however, that TV should not be delayed.