scholarly journals Acute Noninfectious Endophthalmitis after Removal of Silicone Oil and Posterior Capsulectomy in Proliferative Diabetic Retinopathy

2021 ◽  
Vol 62 (10) ◽  
pp. 1445-1448
Author(s):  
Jaehyun Kim ◽  
So Hee Kim ◽  
Youna Choi ◽  
Seung Kwon Choi ◽  
Jae Jung Lee ◽  
...  

Purpose: Here, we report a case of acute noninfectious endophthalmitis after removal of silicone oil (SO) and posterior capsulectomy in a patient with proliferative diabetic retinopathy.Case summary: SO removal and posterior capsulectomy were performed in a 61-year-old man who had undergone vitrectomy with combined cataract surgery, membrane peeling, laser photocoagulation, and SO injection to treat vitreous hemorrhage and tractional retinal detachment three months previously. The patient’s best-corrected visual acuity on the day after surgery was 20/50; it decreased to hand motion at five days after SO removal. Exudative membrane with hypopyon, anterior chamber cell (trace), and mild conjunctival injection were observed. The patient did not complain of ocular pain. Topical steroid was applied following a diagnosis of postoperative noninfectious endophthalmitis. The exudative membrane and hypopyon decreased after three days of treatment and had resolved completely after one month of treatment. The patient’s visual acuity improved to 20/50.Conclusions: Noninfectious endophthalmitis can develop after removal of SO and posterior capsulectomy. Topical steroid treatment is effective in such cases.

Author(s):  
I.A. Frolychev ◽  
◽  
N.A. Pozdeyeva ◽  
◽  
◽  
...  

Surgical treatment of postoperative endophthalmitis is an urgent problem of ophthalmic surgery. Purpose.The aim of the study was to analyze the results of treatment of patients with postoperative endophthalmitis using perfluorodecalin and antibiotic solutions for vitreal cavity tamponade. Materials and methods. For the period 2016-2020, 35 patients (35 eyes) were operated in the Cheboksary branch of the S. Fyodorov Eye Microsurgery Federal State Institution. In 26 patients, this complication occurred after cataract extraction, in 7 after vitreoretinal operations, in 2 after intravitreal administration of an angiogenesis inhibitor. Visual acuity before treatment of endophthalmitis in 3 patients was to 0.02– 0.08, in 16 – counting of fingers in the face, in 13 – pr.l.certa, in 3-pr. l. incerta. All patients underwent vitrectomy with perfluorodecalin tamponade of the vitreal cavity for up to 14 days and intravitreal administration of vancomycin 1 mg and ceftazidime 2.25 mg at the end of the operation. On day 2-3, all patients underwent additional intravitreal administration of antibiotics, depending on the detected pathogen. Further, in 22 patients, the removal of perfluorodecalin and the remaining preretinal and peripherally located exudate was performed, in 13 patients - tamponade of the vitreal cavity with silicone oil. Results. As a result of the treatment according to the developed method, it was possible to preserve visual functions in 32 patients (91%) out of 35. At discharge, the corrected visual acuity was from 0.1 to 0.7 (0.28±0.2). After 6 months, the corrected visual acuity in 32 patients was from 0.1 to 0.9 (0.36±0.2). Visual acuity (above 0.3) was achieved in 26 cases (74.3%). Conclusion. Clinical results demonstrate the effectiveness of the developed method of surgical treatment of endophthalmitis. Key words: postoperative endophthalmitis, perfluorodecalin, intravitreal administration of vancomycin and ceftazidime.


2018 ◽  
Vol 146 (1-2) ◽  
pp. 67-69
Author(s):  
Andrijana Kopic ◽  
Maja Vinkovic ◽  
Suzana Matic ◽  
Nenad Vukojevic

Introduction. The aim of this paper was to present a case of keratouveitis caused by casual handling of a tarantula. Tarantulas, including the Grammostola rosea (Chilean rose), have barbed irritant or urticating hairs, which may be shed during casual handling and in contact with the eye migrate to different parts of the eye and cause inflammatory response known as ophthalmia nodosa. Case outline. A 15-year-old boy presented to our department with a sudden onset of a sore, red left eye, which he noticed after handling his tarantula pet. Slit-lamp examination of the left eye revealed ciliary injection and multiple hairs in all corneal layers. Topical antibiotic and corticosteroid treatment was commenced and there was initial improvement in his clinical status. Three weeks after the initial presentation he developed uveitis and mild macular oedema in his left eye and the best corrected visual acuity in the left eye was reduced. Only local corticosteroid treatment was continued and there was improvement in both the best corrected visual acuity and clinical status of the left eye, while the corneal hairs had not migrated and were still present in all corneal layers despite of long-term tapering regimen of topical steroid therapy. Conclusion. Handling of these increasingly popular exotic pets requires special precautionary measures.


2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Qinxiang Zheng ◽  
Ronghan Wu ◽  
Wensheng Li

Introduction. To report a case of anterior sclera staphyloma and vitreous hemorrhage occurring over 38 years after bilateral cataract surgery.Methods. A 58-year-old man presented with anterior sclera staphyloma and vitreous hemorrhage in the right eye, after bilateral cataract surgery, over 38 years ago. We performed combined anterior sclera staphylectomy and vitrectomy of right eye for anterior sclera staphyloma and vitreous hemorrhage.Results. Forty-eight months after the combined surgery, best-corrected visual acuity was 0.3 (+10.00/−4.50 × 60) with eutopic stitches of the corneoscleral junction on the superior nasal quadrant and a stable ocular surface.Conclusions. This is the first reported case of anterior sclera staphyloma with vitreous hemorrhage successfully managed by combined surgery.


2021 ◽  
Vol 62 (9) ◽  
pp. 1305-1308
Author(s):  
Leeha Kwon ◽  
Yong-Wun Cho ◽  
Seong-Wook Seo ◽  
Seong-Jae Kim ◽  
In Young Chung ◽  
...  

Purpose: To report a case of endophthalmitis and retinal detachment after injury caused by an animal inoculation needle. Case summary: A 39-year-old man received an injury to his left eye with an animal inoculation needle while vaccinating a pig came to the hospital due to decreased visual acuity. At initial presentation, the best-corrected visual acuity in the left eye was “counting fingers,” and slit lamp examination revealed corneal lacerations, anterior capsule rupture, and traumatic cataract. Ultrasonography showed no specific findings in the vitreous and retina. Primary corneal suture, phacoemulsification, anterior vitrectomy due to rupture of the posterior capsule and vitreous prolapse, intraocular lens implantation, and intravitreal antibiotic injection were performed. On day 1 postoperatively, vitrectomy, anterior chamber irrigation, intravitreal antibiotic injection, and silicone oil injection were performed as signs of endophthalmitis, such as hypopyon and retinal tear, and focal retinal detachment were observed during surgery. Silicone oil removal was performed 7 months after the operation and the best-corrected visual acuity was 0.6. There has been no recurrence during follow-up. Conclusions: This is the first report in Korea of ocular injury caused by an animal inoculation needle. If the fundus is not observed in such injuries, there is a possibility of endophthalmitis and retinal detachment and early vitrectomy should be considered.


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Cesar Ramon G. Espiritu ◽  
Mary Ellen A. Sy ◽  
Tommee Lynne G. Tayengco

Background. The use of a fixed-combination antibiotic corticosteroid for infection prophylaxis in Asian patients undergoing phacoemulsification has not been reported.Methods. A 15-day, open-label, single-arm trial of 64 patients for phacoemulsification with intraocular lens (IOL) implantation is described. Patients applied moxifloxacin 0.5%/dexamethasone 0.1% (Vigadexa) eye drops four times daily before and until 15 days after surgery. Anterior chamber (AC) reaction, visual acuity, ocular pain and signs, and intraocular pressure (IOP) were assessed at baseline and on postoperative days 1, 3, 8, and 15.Results. At day 15, 55 (91.7%) patients scored 0 (<5 cells) in AC reaction. No surgery-related infection occurred. Mean best-corrected visual acuity improved 0.5 logMAR from baseline to 0.0 logMAR (P<.0001). Mean IOP remained at 12-13 mm Hg over the 15-day treatment. Only 2 patients (3.1%) reported minimum ocular pain. Two (3.1%) patients were shifted to prednisolone acetate for severe inflammation. At the end of the study period, 8.3% were given fluorometholone for 1 week for AC reaction grade >0. No drug-related adverse event was reported.Conclusion. Following phacoemulsification and IOL implantation, the topical combination moxifloxacin 0.5%/dexamethasone 0.1% was effective in preventing infection and controlling inflammation and was well tolerated.


Author(s):  
Lucio V L Maranhão ◽  
Paulo E C Dantas ◽  
Natalia R L Ramalho ◽  
Wanessa P Pinto

We describe the initial results of a Descemet Membrane Endothelial Keratoplasty (DMEK) procedure for acute corneal hydrops in a 45-years female with keratoconus that presented with severe visual loss in the left eye (OS). The patients’ best-corrected visual acuity at presentation in the right eye was 20/80 and hand motion in OS. Slit-lamp examination revealed an extensive Descemet’s membrane tear and stromal corneal edema in OS. Two months after the DMEK procedure, the patient presented with a best corrected visual acuity of 20/200 in the affected eye, corneal edema improvement, and an attached Descemet graft.  


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yong Koo Kang ◽  
Jae Pil Shin ◽  
Han Sang Park

Purpose. To compare clinical features and microbial profiles, treatment outcomes, and prognostic factors of the eyes between postoperative and posttraumatic bacterial endophthalmitis after pars plana vitrectomy (PPV) with silicone oil (SO) tamponade. Methods. Overall, 57 eyes of 57 patients who diagnosed exogenous bacterial endophthalmitis and underwent PPV with SO tamponade between 2000 and 2019 were reviewed. Causative microorganisms, culture positivity, change of mean best-corrected visual acuity (BCVA), and course of treatment were investigated between postoperative and posttraumatic groups, and relevant factors were analyzed according to the final BCVA. Results. The mean BCVA change was not significantly different between groups. The positive rate of microorganisms was significantly higher in the postoperative group. The mean time to surgery over 48 hours, initial BCVA worse than hand motion, and additional surgery after initial vitrectomy were correlated with poor final BCVA worse than 20/200. There was significantly achieved final BCVA 20/200 or better in the Staphylococcus and Streptococcus group than the Enterococcus and Pseudomonas group. Conclusion. PPV with SO tamponade may be an effective surgical treatment strategy for exogenous bacterial endophthalmitis. Final visual outcomes were not significantly different between postoperative and posttraumatic groups, and the mean time to surgery, initial visual acuity, additional surgery, and type of microorganism are significantly related to visual prognosis.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249139
Author(s):  
Po-Lin Chen ◽  
Yan-Ting Chen ◽  
San-Ni Chen

Objective To compare surgical outcomes between 27 and 25-gauge vitrectomy in proliferative diabetic retinopathy (PDR) with tractional retinal detachment (TRD) Methods This retrospective study was conducted to compare the intraoperative status, operation time, use of instruments, endotamponade substance, wound suture number, and iatrogenic break, between 27 and 25-gauge vitrectomy in 43 eyes afflicted by PDR with TRD. The post-surgical results, best-corrected visual acuity, intraocular pressure, recurrent vitreous haemorrhage, and re-operation rate were regularly followed up for 6 months. Results Patients in the 25 and the 27-gauge groups did not differ significantly in terms of pre-surgical conditions, such as age, gender, pre-existing glaucoma, best-corrected visual acuity (BCVA) and the severity of their TRD. The mean operation time was 56.7 minutes in the 27-gauge group and 63.7 minutes in the 25-gauge group (p = 0.94). There is significantly less use of micro forceps in the 27-gauge group (p = 0.004). No difference between micro scissors and chandelier usage were noted; neither was their difference in iatrogenic retinal breaks. Significantly fewer wound sutures were noted in the 27-gauge group (p < 0.001). The post-operative results revealed no significant difference in ocular hypertension, hypotony, BCVA improvement, recurrent vitreous haemorrhage and re-operation rate. Conclusions The 27-gauge vitrectomy system offers comparable surgical outcomes in PDR with TRD. The 27-gauge vitrectomy system is suitable for complicated retinal surgery.


2021 ◽  
Author(s):  
Hsin-Yu Yang ◽  
Sui-Ching Kao ◽  
Chieh-Chih Tsai ◽  
Wei-Kuang Yu

Abstract Background:CBS is a rare phenomenon which is found during and after cataract surgery. The mechanism, OCT presentation and clinical characteristics are not well studied. Methods:Document patients with CBS who underwent examination, including refraction, best-corrected visual acuity, slit lamp, anterior segment OCT, and onset after cataract surgery. All patients underwent Nd:YAG laser capsulotomy and were prescribed a low-dose topical steroid for seven days. Post-capsulotomy refraction and visual acuity were recorded.Results:This study included 18 eyes. Patients’ mean age was 80 (range, 54–92). The duration between cataract surgery and CBS diagnosis ranged 15–136 months. According to anterior segment OCT findings, we subcategorized the patients into four types: minimally opaque (n=4, 22%), uniformly turbid (n=7, 39%), focally condensed (n=5, 28%), and diffused sparkling (n=2, 11%). After laser capsulotomy, mean visual acuity improved 0.18 ± 0.09 on the LogMar. A significant difference in absolute refraction changes between the groups was noted— maximum in the focally condensed and minimum in the uniformly turbid types. No patient developed complications or needed further treatment for CBS during mean follow-up of 80 months.Conclusion:High-resolution anterior segment OCT is useful for analyzing pathological changes in the CBS. Our study implies that these four types of CBS presentation indicate various causes of late-CBS formation, as well as distinct clinical presentation and post–laser capsulotomy outcome. In addition, YAG laser capsulotomy is a safe late-CBS treatment modality.


Author(s):  
Rachid Zerrouk ◽  
Yassine Malek ◽  
Adil Elkhoyaali ◽  
Yassine Mouzari ◽  
Karim Reda ◽  
...  

Aims: To describe endophthalmitis profile in a tertiary eye care center. Study Design: Retrospective study. Place and Duration of Study: The ophthalmology department of The Mohammed V Military Medical Training Hospital in Rabat, and covering all patients hospitalized for endogenous and exogenous endophthalmitis between January the 1st 2014, and 31 of December 2018. Methodology: We included 41 eyes from 41 patients with endophthalmitis. Results: On a total of 41 eyes, mean age was 53,8 years, with a sex ratio of 1,7. Mean time from onset of symptoms to presentation was 8 +/- 4 days (3 to 32) for postoperative endophthalmitis, and 13 +/- 9 days (2 – 30) for other causes. 98% of patients presented decreased vision, and 88% showed ocular pain. 94% of patients had a visual acuity less than hand motion. Gram positive bacteria were isolated in 76% of the patients. Conclusion: Our epidemiological, clinical and microbial findings are similar to some occidental and other oriental series.


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