4.Analysis of post-operative endophthalmitis after pars plana vitrectomy: a 10-year experience at a single center.
Xiang-yu SHI ; Hong-shu ZHAO ; Wen-bin WEI
Chinese Medical Journal 2013;126(15):2890-2893
BACKGROUNDEndophthalmitis can be a devastating complication after pars plana vitrectomy. The incidence of postvitrectomy endophthalmitis is significantly lower than that of endophthalmitis occurring after other intraocular operations. However, normal post-operative pain and inflammation may mask endophthalmitis and lead to delayed diagnosis and grave visual consequences. This study aimed to summarize the outcomes of cases that underwent pars plana vitrectomy over a 10-year period and to analyze the characteristics of post-vitrectomy endophthalmitis.
METHODSA retrospective observational case study was conducted on all the cases who underwent pars plana vitrectomy in the Beijing Tongren Hospital between January 1, 2002 and March 31, 2012. All cases of endophthalmitis that occurred during a period of 10 years and 3 months were reviewed, and the possible risk factors, clinical findings, causative organism(s), and the sources of infection were analyzed.
RESULTSWithin the 10-year observational period, 14 patients developed endophthalmitis after pars plana vitrectomy. The incidence of post-vitrectomy endophthalmitis (0.05%) was lower than that reported previously from the same center (0.12%). Staphylococcus epidermidis (five patients, 35.71%) was the most common organism identified in aqueous or vitreous cultures. Eight patients (57.14%) had diabetes mellitus. There was no statistically significant difference (P > 0.05) in the incidence of endophthalmitis between period 1 (with antibiotic pretreatment) and period 2 (without antibiotic pretreatment). Surgical procedures for the treatment of endophthalmitis were performed in 10 patients (71.43%).
CONCLUSIONSThis series of cases showed that the incidence of endophthalmitis after pars plana vitrectomy is lower than what was previously reported in our hospital. A variable degree of corneal edema with relatively normal or mildly increased intraocular pressure was one of the commonly observed characteristics of post-vitrectomy endophthalmitis. Staph. epidermidis was the most common causative organism, and antibiotic pretreatment did not lower the incidence of postvitrectomy endophthalmitis.
Adult ; Aged ; Endophthalmitis ; etiology ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Vitrectomy ; methods
5.Case of ophthalmalgia caused by facial paralysis.
Qi-Tai LI ; Lian-Ying LU ; Yan-Yun LIU
Chinese Acupuncture & Moxibustion 2011;31(8):768-768
7.Non-infectious endophthalmitis after vitrectomy.
Yao HUANG ; Ning CHEUNG ; Bei TIAN ; Wen-bin WEI
Chinese Medical Journal 2013;126(8):1436-1439
BACKGROUNDNon-infectious endophthalmitis was reported to occur after cataract surgery or intravitreal injections. This study reported a series of patients having non-infectious endophthalmitis after pars plana vitrectomy in the same two operation rooms during the same period to estimate the risk factors for non-infectious endophthalmitis after vitrectomy.
METHODSMedical records of patients who presented with severe non-infectious endophthalmitis following vitrectomy between May 13 and June 8, 2011, were reviewed. The presenting symptoms and signs were collected, including visual acuity, intraocular pressure, cornea and anterior chamber activity. The treatments and results of microbiology examination were also recorded and analyzed.
RESULTSTen patients were identified with severe non-infectious endophthalmitis, presenting 1 day after pars plana vitrectomy. Three eyes (30%) had previous intraocular surgeries, four (40%) had proliferative diabetic retinopathy, and one (10%) got pars plana vitrectomy combined with phacoemulsification and intraocular lens implantation. All the patients were initially treated with topical and/or oral steroids. Only two patients had intravenous antibiotics because of the atypical presentation. One eye had paracentesis because of high intraocular pressure and the aqueous sample was sent for microbiological examination. The culture of the aqueous, air in the operation room, the swab from hand of surgeons, infusion fluid, and vitrectomy effluent were all negative for bacteria and fungi. The inflammation regressed rapidly after the initial treatment.
CONCLUSIONSIntraocular surgery history, poor general health status, longer operation time, and more surgical procedures are the risk factors for non-infectious endophthalmitis after vitrectomy. It responds well to steroids.
Adult ; Aged ; Dexamethasone ; administration & dosage ; Endophthalmitis ; drug therapy ; etiology ; Female ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Prednisolone ; administration & dosage ; analogs & derivatives ; Vitrectomy ; adverse effects
9.Unilateral Scleral Fixation of Posterior Chamber Intraocular Lenses in Pediatric Complicated Traumatic Cataracts.
Dong Won HYUN ; Tae Gon LEE ; Sung Won CHO
Korean Journal of Ophthalmology 2009;23(3):148-152
PURPOSE: The purpose of this study was to evaluate the visual outcomes and complications of unilateral scleral fixation of posterior chamber intraocular lenses (SF-PCIOLs) in pediatric complicated traumatic cataracts without capsular support. METHODS: This study involved five eyes of five children who underwent unilateral SF-PCIOL. All patients had a unilateral complicated traumatic cataract associated with anterior or posterior segment injury. Visual acuity (VA), IOL position, and postoperative complications were assessed during follow-up. RESULTS: The mean age of patients at the time of SF-PCIOL was 90 months (range, 66-115). The mean duration of follow-up time after surgery was 22 months (range, 5-55). In all patients, the best-corrected VA was either improved or was stable at last follow-up following SF-PCIOL implantation. There were no serious complications. CONCLUSIONS: Unilateral scleral fixation of PCIOL can be a safe and effective procedure for pediatric, unilateral, complicated traumatic cataracts without capsular support in selected cases.
Anterior Eye Segment/injuries
;
Aphakia, Postcataract/*surgery
;
Cataract/*etiology/physiopathology
;
Child
;
Child, Preschool
;
Endophthalmitis/etiology
;
Eye Injuries/*complications
;
Female
;
Follow-Up Studies
;
Humans
;
Lens Implantation, Intraocular/*methods
;
Male
;
Postoperative Period
;
Retrospective Studies
;
Sclera/*surgery
;
*Suture Techniques
;
Visual Acuity
10.Development of Toxic Anterior Segment Syndrome Immediately after Uneventful Phaco Surgery.
Jin Seok CHOI ; Kyung Hwan SHYN
Korean Journal of Ophthalmology 2008;22(4):220-227
PURPOSE: We report on 15 cases of suspected toxic anterior segment syndrome after uneventful phaco surgery. METHODS: We retrospectively reviewed the charts of patients who had developed toxic anterior segment syndrome (TASS) after uneventful phacoemulsification for senile cataracts between April and December of 2005. Clinical features and all possible causes were investigated including irrigating solutions or drugs, surgical instruments or intraocular lenses, sterilization techniques for instruments, or any other accompanying disease. RESULTS: The patients consisted of 2 males and 13 females with an average age of 64.7+/-10.9 years. Five different surgeons had performed their phaco surgeries. No abnormal preoperative or operative findings were reported. Nevertheless, all 15 patients developed a moderate degree of corneal edema. Ordinary treatments were not helpful. We suspect that lack of sterilization resulted in the development of the syndrome, because after ethylene oxide gas sterilization was replaced with autoclaving, no such incidents have occurred. CONCLUSIONS: Toxic anterior segment syndrome requires special attention and thorough management, including sterilization of reused surgical instruments.
Aged
;
Aged, 80 and over
;
Anterior Eye Segment/*pathology
;
Corneal Edema/*etiology/pathology/surgery
;
Endophthalmitis/*etiology/pathology/surgery
;
Endotoxins/adverse effects
;
Female
;
Humans
;
Keratoplasty, Penetrating
;
*Lens Implantation, Intraocular
;
Male
;
Middle Aged
;
*Phacoemulsification
;
*Postoperative Complications
;
Retrospective Studies
;
Syndrome