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International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis: European Vitreo-Retinal Society Endophthalmitis Study Report 1.
Ophthalmol Retina. 2019 06; 3(6):461-467.OR

Abstract

PURPOSE

To study the practice patterns for the management of acute postoperative and postinjection endophthalmitis.

DESIGN

Retrospective, interventional, nonrandomized, multicenter study.

PARTICIPANTS

Data on 237 eyes diagnosed with acute endophthalmitis occurring after intraocular surgery or procedures provided by 57 retina specialists from 28 countries.

MAIN OUTCOME MEASURES

Rates of pars plana vitrectomy (PPV), repeat intravitreal injection, and adjunctive therapeutic regimens (local and systemic antibiotics and steroids).

RESULTS

Of 237 analyzed eyes, acute endophthalmitis secondary to cataract surgery or secondary lens implantation represented 64.6% of cases (153 eyes), whereas the remaining were secondary to intravitreal injections (35 eyes [14.8%]), PPV (29 eyes [12.2%]), and other intraocular surgeries (20 eyes [8.4%]). All eyes received intravitreal antibiotics on the same day of diagnosis. Overall, early PPV was used within the first week of presentation in 176 eyes (74.3%). There was no statistical difference in the proportion of eyes requiring a second intravitreal injection of antibiotics whether the eye was managed primarily with intravitreal antibiotics alone versus early PPV plus intravitreal antibiotics (29.5% [18 eyes] vs. 25.0% [44 eyes], respectively). Adjunctive therapies in the form of intravitreal steroids, systemic steroids, and systemic antibiotics were used in 25.3%, 21.9%, and 66.6% of eyes, respectively. The absence of disc or macular view and absence of endophthalmitis after cataract surgery were associated with an increased likelihood for early PPV (odds ratios 4.1 and 5.1, respectively).

CONCLUSIONS

Pars plana vitrectomy was frequently performed regardless of the presenting vision in eyes with endophthalmitis after cataract surgery and intravitreal injections. Increased vitreous opacification was associated with a higher probability for performing PPV.

Authors+Show Affiliations

Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt; Department of Ophthalmology, University of Ottawa, Ottawa, Canada.Southampton University Hospital NHS Trust, Southampton, United Kingdom.Helen Keller Foundation, Birmingham, Alabama.Instituto de Microcirugía Ocular Córdoba, Córdoba, Argentina.Retina Italy Clinic, Milano, Italy.Department of Ophthalmology, Faculty of Medicine, Gazi University, Ankara, Turkey.Ophthalmic Clinic Jasne Błonia, Lodz, Poland.Capio Augenklinik Universitätsalle, Bremen, Germany.Department of Ophthalmology, Yale University, New Haven, Connecticut.Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Electronic address: ahmedsallam11@yahoo.com.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

31043364

Citation

Soliman, Mohamed K., et al. "International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis: European Vitreo-Retinal Society Endophthalmitis Study Report 1." Ophthalmology. Retina, vol. 3, no. 6, 2019, pp. 461-467.
Soliman MK, Gini G, Kuhn F, et al. International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis: European Vitreo-Retinal Society Endophthalmitis Study Report 1. Ophthalmol Retina. 2019;3(6):461-467.
Soliman, M. K., Gini, G., Kuhn, F., Iros, M., Parolini, B., Ozdek, S., Michalewska, Z., Bopp, S., Adelman, R. A., & Sallam, A. B. (2019). International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis: European Vitreo-Retinal Society Endophthalmitis Study Report 1. Ophthalmology. Retina, 3(6), 461-467. https://doi.org/10.1016/j.oret.2019.03.009
Soliman MK, et al. International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis: European Vitreo-Retinal Society Endophthalmitis Study Report 1. Ophthalmol Retina. 2019;3(6):461-467. PubMed PMID: 31043364.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis: European Vitreo-Retinal Society Endophthalmitis Study Report 1. AU - Soliman,Mohamed K, AU - Gini,Giampoalo, AU - Kuhn,Ferenc, AU - Iros,Mariano, AU - Parolini,Barbara, AU - Ozdek,Sengul, AU - Michalewska,Zofia, AU - Bopp,Silvia, AU - Adelman,Ron A, AU - Sallam,Ahmed B, AU - ,, Y1 - 2019/03/21/ PY - 2018/10/26/received PY - 2019/03/13/revised PY - 2019/03/13/accepted PY - 2019/5/3/pubmed PY - 2020/1/23/medline PY - 2019/5/3/entrez SP - 461 EP - 467 JF - Ophthalmology. Retina JO - Ophthalmol Retina VL - 3 IS - 6 N2 - PURPOSE: To study the practice patterns for the management of acute postoperative and postinjection endophthalmitis. DESIGN: Retrospective, interventional, nonrandomized, multicenter study. PARTICIPANTS: Data on 237 eyes diagnosed with acute endophthalmitis occurring after intraocular surgery or procedures provided by 57 retina specialists from 28 countries. MAIN OUTCOME MEASURES: Rates of pars plana vitrectomy (PPV), repeat intravitreal injection, and adjunctive therapeutic regimens (local and systemic antibiotics and steroids). RESULTS: Of 237 analyzed eyes, acute endophthalmitis secondary to cataract surgery or secondary lens implantation represented 64.6% of cases (153 eyes), whereas the remaining were secondary to intravitreal injections (35 eyes [14.8%]), PPV (29 eyes [12.2%]), and other intraocular surgeries (20 eyes [8.4%]). All eyes received intravitreal antibiotics on the same day of diagnosis. Overall, early PPV was used within the first week of presentation in 176 eyes (74.3%). There was no statistical difference in the proportion of eyes requiring a second intravitreal injection of antibiotics whether the eye was managed primarily with intravitreal antibiotics alone versus early PPV plus intravitreal antibiotics (29.5% [18 eyes] vs. 25.0% [44 eyes], respectively). Adjunctive therapies in the form of intravitreal steroids, systemic steroids, and systemic antibiotics were used in 25.3%, 21.9%, and 66.6% of eyes, respectively. The absence of disc or macular view and absence of endophthalmitis after cataract surgery were associated with an increased likelihood for early PPV (odds ratios 4.1 and 5.1, respectively). CONCLUSIONS: Pars plana vitrectomy was frequently performed regardless of the presenting vision in eyes with endophthalmitis after cataract surgery and intravitreal injections. Increased vitreous opacification was associated with a higher probability for performing PPV. SN - 2468-7219 UR - https://www.unboundmedicine.com/medline/citation/31043364/International_Practice_Patterns_for_the_Management_of_Acute_Postsurgical_and_Postintravitreal_Injection_Endophthalmitis:_European_Vitreo_Retinal_Society_Endophthalmitis_Study_Report_1_ DB - PRIME DP - Unbound Medicine ER -