The role of pars plana vitrectomy in the management of fungal endogenous endophthalmitis

2018 ◽  
Vol 30 (1) ◽  
pp. 88-93 ◽  
Author(s):  
Hande Celiker ◽  
Haluk Kazokoglu

Purpose: To identify the causative microorganism of fungal endogenous endophthalmitis in our tertiary referral uveitis center and review the therapeutic role of pars plana vitrectomy in patients with fungal endogenous endophthalmitis. Methods: Seven eyes of six cases were identified as fungal endogenous endophthalmitis through positive cultures of ocular fluids and clinical presentations. The final anatomical and functional results were evaluated. Results: Four women (66.7%) and two men (33.3%) underwent vitrectomy. Control of infection was achieved early on in all cases. Candida (71.4%) and Aspergillus (28.6%) species were identified as causative fungi in patients with fungal endogenous endophthalmitis. Two patients were reoperated due to reinfection and retinal detachment, respectively. Visual acuity improved in six eyes (85.7%) and worsened in one eye (14.3%). At the final examination, the retina was flat in all cases. No eye developed phthisis bulbi. Conclusion: Candida species are the most common causative organisms of fungal endogenous endophthalmitis in this study. Pars plana vitrectomy in fungal endogenous endophthalmitis may enhance the treatment of infection by removing fungal elements in the vitreous and aid in diagnosis. Vitrectomy may also be an important tool in the management of vision-threatening post-infectious sequelae such as retinal detachment and reinfections.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zheng Ying ◽  
Casagrande Maria ◽  
Dimopoulos Spyridon ◽  
Bartz-Schmidt Karl-Ulrich ◽  
Spitzer Matin Stephan ◽  
...  

Abstract Background To evaluate the rate, risk factors, functional outcome and prognosis in eyes with retinal detachment after post-operative endophthalmitis treated with 23G Pars Plana Vitrectomy. Methods Electronic patient files from 2009 until 2018 were screened for the presence of an endophthalmitis. Included were 116 eyes of 116 patients. This population was evaluated for the rate of retinal detachment after 23G Pars Plana Vitrectomy for endophthalmitis following cataract surgery or intravitreal injection. The main outcome measures were retinal detachment and visual acuity. Results The reasons for endophthalmitis were previous cataract surgery in 78 patients and following intravitreal injection in 38 patients. The first clinical evidence of endophthalmitis was present in median 5 days after the triggering intervention. Twenty-five eyes (21.55%) developed a retinal detachment an average of 25 days after endophthalmitis. RD is significantly associated with preoperative visual acuity (p = 0.001). Conclusions We emphasize the prognostic role of preoperative visual acuity in RD development of the endophthalmitis treated with 23G Pars Plana Vitrectomy.


2021 ◽  
Author(s):  
Ying Zheng ◽  
Maria Casagrande ◽  
Spyridon Dimopoulos ◽  
Ulrich Bartz-Schmidt ◽  
Martin Spitzer ◽  
...  

Abstract Background To evaluate the rate, risk factors, functional outcome and prognosis in eyes with retinal detachment after post-operative endophthalmitis treated with 23G pars plana vitrectomy. Methods Electronic patient files from 2009 until 2018 were screened for the presence of an endophthalmitis. Included were 116 eyes of 116 patients. This population was evaluated for the rate of retinal detachment after 23G Pars Plana Vitrectomy for endophthalmitis following cataract surgery or intravitreal injection. The main outcome measures are retinal detachment and visual acuity. Results Reason for endophthalmitis was previous cataract surgery in 78 patients and following intravitreal injection in 38 patients. First clinical evidence of endophthalmitis was present in median 5 days after the triggering surgery. Twenty-five eyes (21.55%) developed a retinal detachment in average 25 days after endophthalmitis. RD is significantly associated with preoperative visual acuity (p = 0.001). Conclusions Modern 23G vitrectomy technique seems not to lower the rate of retinal detachment after vitrectomy for endophthalmitis. And we also emphasize the prognostic role of preoperative visual acuity in RD development of the endophthalmitis treated with 23G pars plana vitrectomy.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Gian Marco Tosi ◽  
Davide Marigliani ◽  
Tommaso Bacci ◽  
Napoleone Romeo ◽  
Angelo Balestrazzi ◽  
...  

Purpose. To evaluate the effectiveness and safety of perfluorohexyloctane (F6H8) for intraoperative flattening of the retina and of F6H8/silicone oil (SO) 1000 cSt as a postoperative tamponade for inferior retinal detachment with inferior proliferative vitreoretinopathy.Methods. This is a retrospective review of 22 patients who underwent pars plana vitrectomy using F6H8 as an intraoperative tool to flatten the retina. At the end of the surgery a direct partial exchange between F6H8 and SO 1000 cSt was performed, tamponing the eye with different ratios of F6H8/SO (70/30, 60/40, 50/50, 40/30, and 30/70). Anatomical and functional results and complications were evaluated over the follow-up period (mean 22.63 months).Results. F6H8 was efficacious for intraoperative flattening of the retina. Twenty-one of the 22 patients achieved a complete retinal reattachment. Postoperative visual acuity (VA) ranged from light perception to 20/70, with 72% of patients obtaining VA better than 20/400. No emulsification/inflammation was observed whatever the ratio of F6H8/SO used. With higher ratios of F6H8/SO (70/30 and 60/40) cloudiness of the tamponade was observed. A transparent mixture was present with all the other ratios.Conclusions. The surgical technique adopted is very simple and safe. The optimal F6H8/SO ratio seems to be between 50/50 and 30/70.


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Panagiotis Stavrakas ◽  
Paris Tranos ◽  
Angeliki Androu ◽  
Paraskevi Xanthopoulou ◽  
Dimitrios Tsoukanas ◽  
...  

Purpose. In this retrospective study, we evaluated the anatomical and functional outcomes of patients with rhegmatogenous retinal detachment primarily treated with pars plana vitrectomy in regard to the location of the breaks. Methods. 160 eyes were enrolled in this study, divided into two groups based on break location: the superior break group (115 eyes) and the inferior break group (45 eyes). The main endpoint of our study was the anatomical success at 3 months following surgery.Results. Primary retinal reattachment was achieved in 96.5% of patients in group A and in 93.3% in group B (no statistically significant difference, OR 1.98, 95% CI: 0.4, 7.7). Mean BCVA change and intraoperative complication rate were also not statistically significantly different between the two groups (p>0.05, OR: 1.0, 95% CI: 0.9, 1.01, resp.). Statistical analyses showed that macula status, age, and preoperative BCVA had a significant effect on mean BCVA change (p=0.0001,p=0.005, andp=0.001, resp.).Conclusion. This study supports that acceptable reattachment rates can be achieved using PPV for uncomplicated RRD irrespective of the breaks location and inferior breaks do not constitute an independent risk factor for worse anatomical or functional outcome.


Author(s):  
Hammouda Hamdy Ghoraba ◽  
Sameh Mohamed El Gouhary ◽  
Ali Ahmed Ali Ghali ◽  
Mohamed Ahmed Abdelhafez ◽  
Adel Galal Zaky ◽  
...  

Abstract Background To evaluate the results of pars plana vitrectomy (PPV) and silicone oil (SO) tamponade with or without encircling scleral band for repair of rhegmatogenous retinal detachment (RRD) in children with buphthalmos. Patients and methods Retrospective comparative nonrandomized interventional case series including consecutive patients who underwent PPV with or without encircling band and SO tamponade for RRD associated with buphthalmos. Results The study included 19 eyes of 19 children. Mean age was 8 years, range 3–16 years. Mean follow-up period was 28 months, range 19–63 months. Globe survival has been achieved in 15 out of 19 eyes (79%). Phthisis bulbi was reported in four cases (22%). Eight patients (42%) achieved ambulatory vision. Most eyes initially achieved anatomical success. Conclusion Despite the poor visual and anatomical results of RRD repair in eyes with buphthalmos, globe survival might be the rationale for surgery in such cases. Globe preservation could avoid the psychological and social consequences of phthisis bulbi in non-operated children.


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