Comparative Study of Microbiological Profile and Management Outcomes of Acute Endophthalmitis after Microincision Vitrectomy Surgery versus Intravitreal Injections

Ocul Immunol Inflamm. 2021 Jul 4;29(5):838-844. doi: 10.1080/09273948.2019.1695858. Epub 2020 Jan 3.

Abstract

Purpose: The aim of this study was to evaluate and compare incidence and outcomes of management of acute endophthalmitis after microincision vitrectomy surgery (MIVS) and intravitreal injections (IVIs).Methods: Medical records were retrospectively reviewed from January 2012 to December 2017, and the incidence, clinical and microbiological profiles of acute endophthalmitis were documented.Results: Of 26,332 MIVS and 24,143 IVI performed, incidence of acute endophthalmitis in MIVS group was 0.027% (1 in 3761 cases) against 0.054% (1 in 1857 cases) in IVI. Gram-positive organisms were causative in post IVI group as against gram-negative organisms in MIVS group.Conclusion: Incidence of endophthalmitis after IVI is almost twice that after MIVS. A trend toward poorer outcomes in MIVS eyes was observed. Both MIVS and IVI being pars plana procedures warrant similar kind of aseptic precautions.

Keywords: Endophthalmitis; IVI; MIVS; intravitreal injection; pars plana vitrectomy.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Angiogenesis Inhibitors / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Aqueous Humor / microbiology
  • Bevacizumab / administration & dosage
  • Drug Therapy, Combination
  • Endophthalmitis / diagnosis
  • Endophthalmitis / drug therapy
  • Endophthalmitis / epidemiology
  • Endophthalmitis / microbiology*
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / epidemiology
  • Eye Infections, Bacterial / microbiology*
  • Female
  • Glucocorticoids / therapeutic use
  • Gram-Negative Bacteria / isolation & purification*
  • Gram-Positive Bacteria / isolation & purification*
  • Humans
  • Incidence
  • Intravitreal Injections / adverse effects*
  • Male
  • Microsurgery
  • Middle Aged
  • Ranibizumab / administration & dosage
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology
  • Vitrectomy / adverse effects*
  • Vitreous Body / microbiology

Substances

  • Angiogenesis Inhibitors
  • Anti-Bacterial Agents
  • Glucocorticoids
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Ranibizumab