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Endophthalmitis after pars plana vitrectomy - a 15 year prospective study

Session Details

Session Title: Vitreo Retinal Surgery I

Session Date/Time: Thursday 11/09/2014 | 08:00-10:00

Paper Time: 09:12

Venue: Auditorium

First Author: : A.Chandra AUSTRALIA

Co Author(s): :    J. Smith   J. Kam   B. Wang   E. Kurniawan   S. Sandhu   P. Allen

Abstract Details

Purpose:

Endophthalmitis is a rare but devastating complication of intraocular surgery. After pars plana vitrectomy (PPV) surgery, the incidence is even rarer. We present data on post-vitrectomy endophthalmitis (PVE) from a tertiary vitreo-retinal referral centre over 15 years.

Setting:

The Royal Victorian Eye and Ear Hospital, Melbourne, is a tertiary vitreo-retinal referral centre for the state of Victoria, Australia.

Methods:

Presumed PVE diagnoses were made based on strong clinical suspicion by vitreo-retinal surgeons at the study centre between 1997 and 2012. Data was collected on a prospective database.

Results:

A total of 20 cases of PVE were seen over the 15-year period. Eight (40.0%) cases were culture negative, with cultured cases including Staphylococcus epidermis (n=6), Staphylococcus Aureus, bacillus, Streptococcus oralis, and Enterococcus faecalis. Visual outcomes ranged between light perception and 0.1 (LogMAR). A sharp increase in cases was apparent during 2011, when small-gauge sutureless surgery was introduced.

Conclusions:

The most significant finding was that the introduction of small-gauge sutureless surgery increased the rate of PVE. With progression in technology and wound construction, this has since reduced. A wide range of bacteria is responsible for PVE, though staphylococcal genus is the most causative bacteria. Visual outcome is variable and dependant on preoperative ocular condition.

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