Primary small gauge pars plana vitrectomy and silicone oil endotamponade for endophthalmitis after cataract surgery: Clinical and OCT findings

Abstract

Background Retrospective analysis of morphological and functional outcomes after pars-plana vitrectomy and Silicone-Oil (SO) endotamponade in acute postoperative endophthalmitis (APOE). Methods Minimum follow-up was 6 months. Every included patient received best-corrected visual acuity (BCVA) assessment, pre-operatively and at last follow-up. Spectralis OCT was used to investigate disorganization of inner (DRIL) and outer (DROL) retinal layers at 1, 3, 6 months and at last follow-up. OCT-A was performed to assess foveal avascular zone (FAZ) and vascular perfusion density (VPD) at 6 months and at last follow-up. Results Seventeen eyes were recruited. Postoperative findings: BCVA ≥ 20/40 (in 14 eyes); epiretinal membranes (13); hyperreflective epiretinal material soon after surgery in (6) SO-filled eyes; inner retinal layers atrophy (5); macular edema (2); DROL (4) with persistent EZ disruption at final visit (2); no significant difference between study and fellow eyes in central macular thickness, FAZ and VPD; VPD decreased in all cases with prominent disorganization of retinal architecture. Conclusion OCT changes after APOE can be persistent or completely/partially self-resolving and seems related to the outward progression path of the infection/inflammation from the vitreous cavity to the inner and outer retina, rather than to the surgery.

Systematic review of the efficacy and safety of stage I or II IOL implantation in patients with diabetic retinopathy

“…[1][2][3][4][5] With the improvements in ophthalmic microsurgery technology, vitrectomy combined with cataract surgery for diabetic retinopathy has become the main surgical method, [6,7] and most patients need to be filled with silicone oil after vitrectomy. [8][9][10] However, whether an intraocular lens (IOL) should be implanted in stage I after vitrectomy in patients with diabetic retinopathy or stage II implantation during silicone oil filling has been controversial, and there has been no systematic review of this clinical issue. Therefore, to guide clinicians in this surgical approach, we systematically reviewed the efficacy and safety of stage I and II IOL implantation for vitrectomy in patients with diabetic retinopathy.…”