IMMEDIATE VITRECTOMY vs TAP AND INJECT IN EYES WITH ACUTE POSTCATARACT ENDOPHTHALMITIS AND VISUAL ACUITY ≥HM

Abstract

Purpose: To compare the outcomes of immediate pars plana vitrectomy (PPV) and tap and inject in eyes with postcataract surgery endophthalmitis.Methods: Patients presenting with acute postcataract surgery endophthalmitis and visual acuity between $ hand movement and ,6/18 were randomized to receive either PPV (Group A) or tap and inject (Group B).Results: There were 26 and 31 eyes in Group A and Group B, respectively. The final mean visual acuity at 6 weeks [0.14 (Snellen equivalent 6/7.5) versus 0.22 (Snellen equivalent 6/9.5) LogMAR in Groups A and B, respectively; P = 0.2] was similar. However, eyes in Group A had significantly greater mean letter gain in vision compared with Group B (66.36 vs. 43.36, P = 0.02), and more eyes in Group A (88%) than in Group B (65%) attained a visual acuity of $ 6/18 (P = 0.06). Eyes in Group B needed more reinterventions including delayed vitrectomy after tap and inject than those in Group A (39% vs. 8%; P = 0.09). On subgroup analysis, the mean visual acuity at the final follow-up was significantly better in the immediate PPV group compared with the delayed PPV group (P = 0.04).Conclusion: PPV resulted in earlier recovery, lesser interventions, and greater change in visual acuity than tap and inject in eyes with postcataract surgery endophthalmitis presenting with visual acuity of $HM.

Bacterial endophthalmitis following anti-VEGF intravitreal injections: a retrospective case series

“…This study also highlights concerns regarding the repackaging and pooling methods of bevacizumab, which may be associated with a higher risk of endophthalmitis development. Additionally, it raises questions about the role of early PPV in the management of acute endophthalmitis after cataract extraction, as recently discussed on a randomized clinical trial conducted by Sen et al [ 26 ].…”

Letter to the Editor

“…We commend Sen et al 1 for their article titled "Immediate Vitrectomy vs Tap and Inject in eyes with Acute Postcataract endophthalmitis and visual acuity $HM: A Randomized Clinical Trial." The authors compared immediate pars plana vitrectomy (PPV) versus primary tap and injection in management of postcataract surgery endophthalmitis (PCE).…”

“…We commend Sen et al 1 for their article titled “Immediate Vitrectomy vs Tap and Inject in eyes with Acute Postcataract endophthalmitis and visual acuity ≥HM: A Randomized Clinical Trial.” The authors compared immediate pars plana vitrectomy (PPV) versus primary tap and injection in management of postcataract surgery endophthalmitis (PCE). The incidence of PCE is quite rare, and only 57 of 164,366 patients who underwent cataract study met the study's inclusion and exclusion criteria while also consenting to receive treatment.…”

Author’s reply

“…Of 164,366 eyes that underwent cataract surgery during the study period, 84 developed endophthalmitis. 1 However, only 60 eyes met the inclusion criteria, and 57 completed the predefined follow-up.…”