Ten-year trends in the incidence, clinical profile and outcomes of acute-onset endophthalmitis following combined pars plana vitrectomy and sutureless, glueless and flapless scleral fixation of intraocular lenses.

Abstract

PURPOSE:

To evaluate the frequency and outcomes of acute-onset endophthalmitis following combined pars plana vitrectomy and scleral fixation of intraocular lens.

METHODS:

We evaluated patients undergoing a sutureless, glueless, flapless technique of scleral fixation of intraocular lenses (SFIOL) implantation for various causes of aphakia and documented the clinico-demographic data, microbiological profile and final outcome after acute endophthalmitis in this cohort of eyes.

RESULTS:

The frequency of suspected acute endophthalmitis diagnosed post-surgery was 0.112% (4/3541 eyes), with culture-positive endophthalmitis frequency being 0.028% (1 eye), showing growth of Pseudomonas aeruginosa. Mean age of patients with endophthalmitis was 51.75 ± 9.28 years, and mean interval between surgery and acute endophthalmitis presentation was 10.25 ± 9.6 days. Patients were managed with intravitreal antibiotics with or without core vitrectomy. Visual acuity of patients increased from baseline 1.43 ± 0.32 logMAR (Snellen equivalent = 6/150) to 0.79 ± 0.16 logMAR (Snellen equivalent = 6/36) after an average follow-up of 11 ± 2 weeks.

CONCLUSION:

Endophthalmitis is a rare complication following SFIOL surgery, and all ophthalmic surgeons must be aware of this inadvertent possibility, since SFIOLs are gaining wider acceptability recently. Moreover, these cases of endophthalmitis may show a different pattern of microorganisms than post-cataract surgery endophthalmitis; however, with prompt diagnosis and effective timely management, favorable outcomes can be achieved.

• Authors: Naresh Babu Kannan, Sagnik Sen, Chitaranjan Mishra, Prajna Lalitha, Gunasekaran Rameshkumar, Karthik Kumar, Renu P Rajan, Kim Ramasamy
• Journal: International ophthalmology (Int Ophthalmol) Vol. 41 Issue 5 Pg. 1651-1658 (May 2021) ISSN: 1573-2630 [Electronic] Netherlands
• PMID: 33511515 (Publication Type: Journal Article)

Topics

• Adult
• Endophthalmitis (diagnosis, epidemiology, etiology)
• Humans
• Incidence
• Lenses, Intraocular
• Middle Aged
• Postoperative Complications (epidemiology)
• Retrospective Studies
• Vitrectomy