Endophthalmitis in Microincision Vitrectomy

Abstract

Endophthalmitis was a rare occurrence in this large series of gas-filled eyes after macular hole surgery (0.04%). Gas endotamponade after microincision sutureless vitrectomy may be beneficial in reducing the risk of postoperative endophthalmitis; however, additional studies are necessary to make a definitive recommendation.

Chronic Postoperative Endophthalmitis: A Review of Clinical Characteristics, Microbiology, Treatment Strategies, and Outcomes

“…Endophthalmitis also has been reported following external ocular surgeries such as scleral buckle, pterygium excision, and strabismus surgeries [11]. The highest endophthalmitis rate was found in surgical procedures associated with cataract extraction reaching 0.367%; on the other hand, pars plana vitrectomy was found to have the lowest incidence rate with only 0.04% especially after using microincision technique [11, 13]. …”

“…Another approach depends on the type of the isolated organism whereby S. epidermidis could be treated with intraocular antibiotic injections alone while P. acnes would require surgical intervention with pars plana vitrectomy, capsulectomy and possible removal or exchange of the IOL in addition to intraocular antibiotic injection [13, 20, 44]. This is based on the fact that multiple reports described high rate of recurrence when P. acnes CPE was treated with intravitreal antibiotics alone [20, 44].…”

Endophthalmitis following pars plana vitrectomy: a literature review of incidence, causative organisms, and treatment outcomes

“…It was hypothesized that balanced salt solution is likely to provide poorer wound integrity at the sclerotomy site compared with tamponade agents due to different surface tension properties. Higher surface tension properties of air, gas, and silicone oil may prevent fluid from egressing across the sclerotomy 37. It is also suspected that air, gas, and silicone oil do not support bacterial growth as well as balanced salt solution.…”

Transvitreal Fibrinoid Pseudoendophthalmitis After Diabetic Vitrectomy

“…The incidence of endophthalmitis after vitrectomy has varied in the literature from a historical and an institutional standpoint, with a range from 0% to 0.84%. 1,2 Currently accepted interventions for infectious endophthalmitis include tap and intravitreal injection of antibiotic with or without pars plana vitrectomy.…”