Visual outcome of 25 Gauge vitrectomy for acute post operative infectious endophthalmitis

Article type: Research Article

Authors: Zhao, Wei-Feng^{a; 1} | He, Wei^{a; 1} | Han, Quan-Hong^{b; *} | Qi, Shi-Xin^{a; *}

Affiliations: [a] Department of Ophthalmology, Baodi Clinical College, Tianjin Medical University, Tianjin, China | [b] Vitreous Retinal Branch, Tianjin Eye Hospital, Tianjin, China

Correspondence: [*] Corresponding authors: Quan-hong Han, Vitreous Retinal Branch, Tianjin Eye Hospital, No. 4 Gansu Road, Heping District, Tianjin 300020, China. E-mail: hanquanhongspr@126.com. Shi-Xin Qi, Department of Ophthalmology, Baodi Clinical Colledge of Tianjin Medical University, No. 8 of Guangchuan Road, Baodi District, Tianjin 301800, China. E-mail: qishixinqsh@126.com.

Note: [1] These authors contributed equally to this study.

Abstract: BACKGROUND: The correlation between the change in foveal thickness measured using optical coherence tomography (OCT) following surgery for infectious endophthalmitis and preoperative and postoperative visual acuity is uncertain, and there are few pertinent studies on this topic. OBJECTIVE: We explored the variations in macular thickness using OCT after emergency vitrectomy for post-cataract infectious endophthalmitis and the relationship between macular thickness with changes in visual function. METHODS: We included 10 cases of post-cataract infectious endophthalmitis. Each patient underwent 25-G vitrectomy. RESULTS: The infection in all 10 patients was under control and visual function improved. Postoperative vitreous humor culture was positive in 8 patients, including 7 cases of coagulase-negative Staphylococcus epidermidis and 1 case of Lactobacillus acidophilus. The average age of these 10 patients was 71.60 ± 8.71 years (P< 0.05, two-tailed). There was no significant correlation between time 2 (the time of onset after cataract surgery) and visual prognosis. The average time 1 (the time of the vitrification surgery caused by the onset of the disease) was 1.45 ± 0.76 days (P< 0.05, two-tailed). The postoperative 3dVA ranged from 0.20 to 3.00, with an average visual acuity of 1.87 ± 1.12, which was superior to the preoperative value (P< 0.01, two-tailed). The correlation between the post3dVA and post 1mVA was significant. The post 1mVA ranged from 0.05 to 2.20, with an average visual acuity of 0.94 ± 0.74 (P< 0.05, two-tailed). The correlation between post 1mVA and post3mVA was significant. Also, paired t-tests comparing preoperative and postoperative visual acuity revealed a significant correlation (P< 0.05, two-tailed). The post3mVA was 0–1.00 with an average visual acuity of 0.44 ± 0.41. The postoperative foveal thickness ranged from 176.00 to 514.00 μm, with an average thickness of 281.10 ± 113.12 μm. CONCLUSION: Emergency 25-G minimally invasive vitrectomy can improve visual acuity and decrease the reoperation rate for patients who have acquired post-cataract infectious endophthalmitis. There were significant correlations between age, disease onset to operation time, preoperative and postoperative visual acuity, and postoperative macular thickness.

Keywords: Coagulase-negative Staphylococcus epidermidis, infectious endophthalmitis, optical coherence tomography, preoperative logarithm of the minimum angle of resolution, visual acuity, 25-G minimally invasive vitrectomy

DOI: 10.3233/THC-230607

Journal: Technology and Health Care, vol. 32, no. 2, pp. 1099-1110, 2024