Immediate Vitrectomy for Acute Endophthalmitis in Patients with a Visual Acuity of Hand Motion or Better.

Q3 Medicine
Korean Journal of Ophthalmology : KJO Pub Date : 2022-10-01 Epub Date: 2022-08-19 DOI:10.3341/kjo.2022.0014
Jaemin Kim, Hyoung Seok Kim, Su Jin Yoo, Moon Jung Choi, Youngju Lew, Jong Woo Kim, Han Joo Cho
{"title":"Immediate Vitrectomy for Acute Endophthalmitis in Patients with a Visual Acuity of Hand Motion or Better.","authors":"Jaemin Kim,&nbsp;Hyoung Seok Kim,&nbsp;Su Jin Yoo,&nbsp;Moon Jung Choi,&nbsp;Youngju Lew,&nbsp;Jong Woo Kim,&nbsp;Han Joo Cho","doi":"10.3341/kjo.2022.0014","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To determine the efficacy of immediate pars plana vitrectomy as the primary treatment for acute endophthalmitis in patients with a visual acuity (VA) of hand motion (HM) or better.</p><p><strong>Methods: </strong>A total of 149 patients who were referred to a single center for acute endophthalmitis after cataract surgery over the 13-year study period were retrospectively analyzed. Only patients presenting with a VA of at least HM were included. Patients were initially treated with either primary vitrectomy or intravitreal antibiotic injection alone, and their visual outcomes and reintervention rates after initial treatment were compared.</p><p><strong>Results: </strong>There was no significant difference in the proportion of good (final VA ≥20 / 40) and poor (VA ≤ counting finger) visual outcomes between the groups. However, subgroup analysis of patients with a VA of HM (92 eyes) showed that the incidence of reintervention (14 of 72 eyes [19.4%] vs. 9 of 20 eyes [45.0%]) and poor visual outcomes (10 of 72 eyes [13.9%] vs. 8 of 20 eyes [40.0%]) were lower after prompt vitrectomy than after intravitreal antibiotic injection alone (p = 0.019 and p = 0.022, respectively). For those with a VA of at least counting finger, no significant difference was observed between the groups.</p><p><strong>Conclusions: </strong>For patients with endophthalmitis presenting with a VA of HM, performing a prompt vitrectomy reduced the incidence of reintervention and poor visual outcomes than the administration of intravitreal antibiotics alone. Our results suggest that primary vitrectomy for patients with endophthalmitis presenting with a VA of HM could be more beneficial than intravitreal antibiotic injection alone.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":" ","pages":"390-397"},"PeriodicalIF":0.0000,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/65/kjo-2022-0014.PMC9582504.pdf","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Korean Journal of Ophthalmology : KJO","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3341/kjo.2022.0014","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/8/19 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1

Abstract

Purpose: To determine the efficacy of immediate pars plana vitrectomy as the primary treatment for acute endophthalmitis in patients with a visual acuity (VA) of hand motion (HM) or better.

Methods: A total of 149 patients who were referred to a single center for acute endophthalmitis after cataract surgery over the 13-year study period were retrospectively analyzed. Only patients presenting with a VA of at least HM were included. Patients were initially treated with either primary vitrectomy or intravitreal antibiotic injection alone, and their visual outcomes and reintervention rates after initial treatment were compared.

Results: There was no significant difference in the proportion of good (final VA ≥20 / 40) and poor (VA ≤ counting finger) visual outcomes between the groups. However, subgroup analysis of patients with a VA of HM (92 eyes) showed that the incidence of reintervention (14 of 72 eyes [19.4%] vs. 9 of 20 eyes [45.0%]) and poor visual outcomes (10 of 72 eyes [13.9%] vs. 8 of 20 eyes [40.0%]) were lower after prompt vitrectomy than after intravitreal antibiotic injection alone (p = 0.019 and p = 0.022, respectively). For those with a VA of at least counting finger, no significant difference was observed between the groups.

Conclusions: For patients with endophthalmitis presenting with a VA of HM, performing a prompt vitrectomy reduced the incidence of reintervention and poor visual outcomes than the administration of intravitreal antibiotics alone. Our results suggest that primary vitrectomy for patients with endophthalmitis presenting with a VA of HM could be more beneficial than intravitreal antibiotic injection alone.

即时玻璃体切除术治疗手活动或更好视力的急性眼内炎。
目的:探讨直接玻璃体切割术治疗手活动(HM)及以上视力患者急性眼内炎的疗效。方法:回顾性分析我院13年来收治的149例白内障术后急性眼内炎患者。仅包括VA至少为HM的患者。患者最初接受玻璃体切除术或玻璃体内单独注射抗生素治疗,并比较初始治疗后的视力结果和再干预率。结果:两组患者视觉效果良好(终VA≥20 / 40)和差(VA≤数指)的比例差异无统计学意义。然而,对92只眼的VA患者的亚组分析显示,及时玻璃体切除术后再干预发生率(72只眼中14只[19.4%]比20只眼中9只[45.0%])和视力不良发生率(72只眼中10只[13.9%]比20只眼中8只[40.0%])低于单纯玻璃体内注射抗生素(p = 0.019和p = 0.022)。对于那些VA至少有数指的人来说,两组之间没有明显的差异。结论:对于表现为眼内炎VA的HM患者,及时行玻璃体切除术比单独使用玻璃体内抗生素减少了再干预和视力不良的发生率。我们的研究结果表明,原发性玻璃体切除术可能比单纯玻璃体内注射抗生素更有益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Korean Journal of Ophthalmology : KJO
Korean Journal of Ophthalmology : KJO Medicine-Ophthalmology
CiteScore
2.40
自引率
0.00%
发文量
84
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信