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    ACUTE-ONSET ENDOPHTHALMITIS AFTER CATARACT SURGERY Success of Initial Therapy, Visual Outcomes, and Related Factors
    (Lippincott Williams & Wilkins, 2009) Altan, Tugrul; Acar, Nur; Kapran, Ziya; Unver, Yaprak Banu; Yurttaser, Serap; Kucuksumer, Yasar; Eser, Ilker
    Purpose: To evaluate the success of initial treatment and the factors influencing the outcome in acute-onset endophthalmitis after cataract surgery. Methods: We retrospectively reviewed the medical records of all patients with acute postoperative endophthalmitis between 2000 and 2007. We performed pars plana vitrectomy (PPV) to all eyes with initial visual acuity of light perception. Eyes with visual acuity of hand motions or better underwent either intraocular antibiotic injection (IOAI) or PPV. Eyes that did not give a good clinical response to initial therapy within 60 hours underwent a second procedure. The main outcome measure was the rate of early reintervention after PPV and IOAI. Results: We evaluated 88 eyes of 88 patients. Thirty-seven patients underwent PPV and 51 patients underwent IOAI alone. Six of 37 (16.2%) patients required 1 or more procedures within 60 hours of the initial procedure in the PPV group. Twenty-eight of 51 eyes (54.9%) in the IOAI group underwent PPV within 60 hours. The rate of response to primary PPV was significantly higher than to primary IOAI (P < 0.001). Gram-negative organisms composed 35.1% of the isolates. Conclusion: Pars plana vitrectomy may be preferable to IOAI in postoperative endophthalmitis since the rate of early reintervention is lower with initial PPV. RETINA 29:606-612, 2009
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    Öğe
    Comparative outcomes of pars plana vitrectomy in acute postoperative endophthalmitis with 25-gauge and 20-gauge techniques
    (Springer Tokyo, 2009) Altan, Tugrul; Kapran, Ziya; Eser, Ilker; Acar, Nur; Uenver, Yaprak Banu; Yurttaser, Serap
    To evaluate the safety and outcomes of 25-gauge pars plana vitrectomy (PPV) in the treatment of postoperative endophthalmitis and compare it with 20-gauge PPV. The medical records of all patients diagnosed with acute endophthalmitis following cataract surgery who underwent PPV between December 2000 and December 2007 were reviewed. Main outcome measures included final visual acuity (VA), additional interventions, and both intraoperative and postoperative complications. Records of 70 eyes of 70 patients with a condition diagnosed as postoperative endophthalmitis were evaluated. Fifty-eight eyes underwent 20-gauge PPV (group 1), and 12 eyes underwent 25-gauge PPV (group 2). Mean follow-up time for group 1 was 9.6 +/- 8.8 months, and for group 2, 7.9 +/- 12.7 months (P = 0.57). Median VA at presentation was hand motion in both groups. The differences between the two groups in frequencies of visual outcome levels of 20/800 and 20/100 were significant in favor of group 2 (20/800, P = 0.006; 20/100, P = 0.01). In group 2, fewer additional interventions were required, and postoperative complications tended to be less frequent. Twenty-five-gauge PPV seems to be safe and effective in the management of postoperative endophthalmitis. This sutureless technique may have some advantages over 20-gauge surgery, but controlled studies are needed to confirm the results.