Session Title: Vitreoretinal Surgery II
Session Date/Time: Thursday 26/09/2013 | 14:30-16:00
Paper Time: 15:10
Venue: Hall 3 (Level 0)
First Author: C.Chiquet FRANCE
Co Author(s): C. Creuzot A. Combey de Lambert G. Thuret P. Cornut
To report visual and anatomical outcome of patients vitrectomized for acute post bacterial endophthalmitis.
University Hospital of Grenoble, Lyon, Dijon and Saint-Etienne, France
123 patients with acute postcataract endophthalmitis and consecutively treated by pars plana vitrectomy (PPV) were included in four academic hospitals (French Institutional Endophthalmitis Study (FRIENDS) group). Risk factors of visual outcome and retinal detachment (RD) were analyzed using univariate analysis.
At 6 month follow-up, 49 patients (40%) had a visual acuity (VA) greater than or equal to 20/40, and 84 patients (68%) had VA greater than or equal to 20/200. Baseline clinical factors associated with final VA< 20/100 were VA limited to LP at presentation (OR= 1.6 (1.1-2.4), p=0.02), hypopion (OR= 1.4(1.1-1.8), p=0.02), fundus visibility at admission (OR= 0.6(0.5-0.8), p=0.03), duration of PPV (OR= 0.97 (0.96-0.99), p= 0.007), and identification of virulent bacteria (vs CNS and sterile, OR= 3 (1.9-4.7), p<0.0001). Ocular complications occurred in 58% of the patients, including phthysis (8%), RD (13%), epiretinal membrane (15%), macular edema (11%), choroidal detachment (5%) and posterior synechia (14%). Risk factors of RD were diabetes (OR = 4.7 (1.4-15.4), p=0.01), and visualization of retinal vasculitis on the posterior pole (OR = 3.8 (1.1-13.9), p= 0.03) at the time of PPV.
PPV allowed to be beneficial in a majority of the patients. RD remains the major complications, surgery of RD can be performed in almost all cases but final anatomical and visual results remains poor, despite updated vitreoretinal techniques.