3.Case of ophthalmalgia caused by facial paralysis.
Qi-Tai LI ; Lian-Ying LU ; Yan-Yun LIU
Chinese Acupuncture & Moxibustion 2011;31(8):768-768
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
8.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.Bilateral Endophthalmitis as the Initial Presentation of Bacterial Meningitis.
Seong Jae KIM ; Seong Wook SEO ; Jong Moon PARK ; In Young CHUNG
Korean Journal of Ophthalmology 2009;23(4):321-324
To report a case of bilateral endophthalmitis as the initial presentation of bacterial meningitis in a young, immunocompetent Korean patient. A 35-year-old female with a one day history of bilateral swollen eyes, visual disturbance, headache, petechial skin rash, and nausea visited our clinic. She was diagnosed as having endogenous endophthalmitis associated with bacterial meningitis. Intravenous broad spectrum antibiotic therapy was initiated with cefotaxime 3 g and ubacillin 3 g, four times daily. Intravitreal antibiotic (vancomycin 1 mg/0.1 mL and ceftazidime 2 mg/0.1 mL) injections were performed in both eyes. Two weeks post presentation, the best corrected visual acuity in both eyes improved to 0.7, and inflammation of the anterior chamber and vitreous cavity was decreased. We recommend that when endogenous endophthalmitis is suspected along with meningitis, or if it is known to be present, intravitreal and intravenous antibiotics should be promptly administered to preserve vision.
Adult
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Anti-Bacterial Agents/therapeutic use
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Diagnosis, Differential
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Endophthalmitis/diagnosis/drug therapy/*etiology
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Eye Infections, Bacterial/diagnosis/drug therapy/*etiology
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Female
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Follow-Up Studies
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Humans
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Meningitis, Bacterial/*complications/diagnosis/drug therapy
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Ophthalmoscopy
10.Traumatic endophthalmitis following penetrating ocular injuries with retained intraocular foreign bodies.
Cai-hui JIANG ; Mao-nian ZHANG
Chinese Journal of Traumatology 2003;6(3):167-170
OBJECTIVETo evaluate the outcome and analyze the methods of surgical treatment of traumatic endophthalmitis following penetrating eye injuries with retained eye foreign bodies.
METHODSA total of 62 consecutive cases (58 men, 4 women) from January 1999 to December 2001 with IOFBs following penetrating eye injuries were retrospectively studied. The ages ranged from 8 to 46 years (mean 23 years). Sixty patients (63 eyes) underwent pars plana vitreotomy and 1 patient underwent external magnet extraction. The follow-up ranged from 3 to 36 months (mean 12.5 months).
RESULTSTen eyes developed endophthalmitis, among which 7 (10.94%) were diagnosed preoperatively. The most frequently cultured organism was Staphylococcus epidermis (44.44%, 4/9). Postoperatively, retinal detachment due to vitreoretinal proliferation occurred in 5 patients with endophthalmitis and in 9 patients without endophthalmitis. All the retinal detachments were reattached with additional vitreoretinal surgery. Two eyes with endophthalmitis and two without endophthalmitis were eviscerated.
CONCLUSIONSPost-traumatic endophthalmitis with intraocular foreign bodies (IOFBs) deserves great attention because of its high incidence and poor prognosis. Vitrectomy is suggested for the treatment of IOFBs and its complications, and it should be performed as soon as possible. Routine intravenous administration of antibiotics combined with periocular injection and topical antibiotics postoperatively are recommended.
Adolescent ; Adult ; Anti-Bacterial Agents ; therapeutic use ; Child ; Endophthalmitis ; etiology ; Eye Foreign Bodies ; complications ; therapy ; Eye Infections, Bacterial ; drug therapy ; etiology ; Eye Injuries, Penetrating ; complications ; therapy ; Female ; Humans ; Injections ; Male ; Middle Aged ; Vitrectomy