Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis

David RP Almeida,1 Eric K Chin,2,3 Shaival S Shah,3 Benjamin Bakall,3 Karen M Gehrs,3 H Culver Boldt,3 Stephen R Russell,3 James C Folk,3 Vinit B Mahajan3,41VitreoRetinal Surgery PA, Minneapolis, MN, 2Retina Consultants of Southern California, Riverside, CA, 3Vitreoretinal Service, Department of Oph...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Almeida DRP, Chin EK, Shah SS, Bakall B, Gehrs KM, Boldt HC, Russell SR, Folk JC, Mahajan VB
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Endophthalmitis Vitrectomy Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/00e72faae1fd43f3a5784cb43f418392
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:00e72faae1fd43f3a5784cb43f418392
record_format	dspace
spelling	oai:doaj.org-article:00e72faae1fd43f3a5784cb43f4183922021-12-02T04:02:54ZComparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis1177-5483https://doaj.org/article/00e72faae1fd43f3a5784cb43f4183922016-01-01T00:00:00Zhttps://www.dovepress.com/comparison-of-microbiology-and-visual-outcomes-of-patients-undergoing--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483David RP Almeida,1 Eric K Chin,2,3 Shaival S Shah,3 Benjamin Bakall,3 Karen M Gehrs,3 H Culver Boldt,3 Stephen R Russell,3 James C Folk,3 Vinit B Mahajan3,41VitreoRetinal Surgery PA, Minneapolis, MN, 2Retina Consultants of Southern California, Riverside, CA, 3Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, 4Omics Laboratory, University of Iowa, Iowa City, IA, USABackground: The role of pars plana vitrectomy (PPV) for endophthalmitis has evolved over recent decades but the literature is lacking on comparisons between small-gauge and 20-gauge vitrectomy.Objective: To evaluate evolving etiological and microbiological trends in patients undergoing vitrectomy for endophthalmitis and to compare culture-positive rates and visual outcomes between small-gauge (23- and 25-gauge) and 20-gauge instrumentation during vitrectomy for endophthalmitis.Methods: Ten-year retrospective comparative case series and prospective laboratory in vitro testing. Tertiary care academic referral center. Patients who underwent PPV for endophthalmitis between 2003 and 2013. Vitreous biopsies were obtained in all cases. The effect of vitrectomy gauge (20-, 23-, and 25-gauge) and vitreous cutting rate (1,500 and 5,000 cuts per minute) on the viability of bacterial culture was evaluated in an in vitro prospective laboratory investigation.Main outcome measures: Comparison of etiology, microbiology culture-positive rates, and visual outcomes between small-gauge and 20-gauge instrumentation in patients undergoing PPV for infectious endophthalmitis.Results: A total of 61 cases of vitrectomy for endophthalmitis were identified over a 10-year period; of these, 34 were treated with small-gauge (23- and 25-gauge) vitrectomy and 27 were treated with 20-gauge vitrectomy. In the small-gauge group, 12 cases (35.3%) yielded culture-positive results versus 20 cases (74.1%) with culture positivity in the 20-gauge cohort (P=0.002). The most common cause of endophthalmitis was cataract surgery and the most frequently identified organism was coagulase-negative Staphylococci in both groups. There was no significant difference in mean postoperative visual acuities between groups (P=0.33). Etiological trends indicate an increase in endophthalmitis due to intravitreal injection in the small-gauge group (n=9) compared to the 20-gauge group (n=3) (P=0.001). In vitro laboratory testing revealed no significant difference in rates of culture growth for different vitrectomy gauge sizes or vitreous cutting speeds.Conclusion and relevance: Small-gauge vitrectomy for endophthalmitis yields final visual outcomes comparable to 20-gauge instrumentation. A significant difference in culture-positive rates was observed between small-gauge and 20-gauge instrumentation for vitrectomy in endophthalmitis; however, laboratory testing indicates this is not related to either vitreous gauge size or cutter speed. Intravitreal injections are emerging as a common etiology of vitrectomy for endophthalmitis.Keywords: endophthalmitis, vitrectomy, vitreous biopsyAlmeida DRPChin EKShah SSBakall BGehrs KMBoldt HCRussell SRFolk JCMahajan VBDove Medical PressarticleEndophthalmitisVitrectomyOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2016, Iss Issue 1, Pp 167-172 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Endophthalmitis Vitrectomy Ophthalmology RE1-994
spellingShingle	Endophthalmitis Vitrectomy Ophthalmology RE1-994 Almeida DRP Chin EK Shah SS Bakall B Gehrs KM Boldt HC Russell SR Folk JC Mahajan VB Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis
description	David RP Almeida,1 Eric K Chin,2,3 Shaival S Shah,3 Benjamin Bakall,3 Karen M Gehrs,3 H Culver Boldt,3 Stephen R Russell,3 James C Folk,3 Vinit B Mahajan3,41VitreoRetinal Surgery PA, Minneapolis, MN, 2Retina Consultants of Southern California, Riverside, CA, 3Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, 4Omics Laboratory, University of Iowa, Iowa City, IA, USABackground: The role of pars plana vitrectomy (PPV) for endophthalmitis has evolved over recent decades but the literature is lacking on comparisons between small-gauge and 20-gauge vitrectomy.Objective: To evaluate evolving etiological and microbiological trends in patients undergoing vitrectomy for endophthalmitis and to compare culture-positive rates and visual outcomes between small-gauge (23- and 25-gauge) and 20-gauge instrumentation during vitrectomy for endophthalmitis.Methods: Ten-year retrospective comparative case series and prospective laboratory in vitro testing. Tertiary care academic referral center. Patients who underwent PPV for endophthalmitis between 2003 and 2013. Vitreous biopsies were obtained in all cases. The effect of vitrectomy gauge (20-, 23-, and 25-gauge) and vitreous cutting rate (1,500 and 5,000 cuts per minute) on the viability of bacterial culture was evaluated in an in vitro prospective laboratory investigation.Main outcome measures: Comparison of etiology, microbiology culture-positive rates, and visual outcomes between small-gauge and 20-gauge instrumentation in patients undergoing PPV for infectious endophthalmitis.Results: A total of 61 cases of vitrectomy for endophthalmitis were identified over a 10-year period; of these, 34 were treated with small-gauge (23- and 25-gauge) vitrectomy and 27 were treated with 20-gauge vitrectomy. In the small-gauge group, 12 cases (35.3%) yielded culture-positive results versus 20 cases (74.1%) with culture positivity in the 20-gauge cohort (P=0.002). The most common cause of endophthalmitis was cataract surgery and the most frequently identified organism was coagulase-negative Staphylococci in both groups. There was no significant difference in mean postoperative visual acuities between groups (P=0.33). Etiological trends indicate an increase in endophthalmitis due to intravitreal injection in the small-gauge group (n=9) compared to the 20-gauge group (n=3) (P=0.001). In vitro laboratory testing revealed no significant difference in rates of culture growth for different vitrectomy gauge sizes or vitreous cutting speeds.Conclusion and relevance: Small-gauge vitrectomy for endophthalmitis yields final visual outcomes comparable to 20-gauge instrumentation. A significant difference in culture-positive rates was observed between small-gauge and 20-gauge instrumentation for vitrectomy in endophthalmitis; however, laboratory testing indicates this is not related to either vitreous gauge size or cutter speed. Intravitreal injections are emerging as a common etiology of vitrectomy for endophthalmitis.Keywords: endophthalmitis, vitrectomy, vitreous biopsy
format	article
author	Almeida DRP Chin EK Shah SS Bakall B Gehrs KM Boldt HC Russell SR Folk JC Mahajan VB
author_facet	Almeida DRP Chin EK Shah SS Bakall B Gehrs KM Boldt HC Russell SR Folk JC Mahajan VB
author_sort	Almeida DRP
title	Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis
title_short	Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis
title_full	Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis
title_fullStr	Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis
title_full_unstemmed	Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis
title_sort	comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/00e72faae1fd43f3a5784cb43f418392
work_keys_str_mv	AT almeidadrp comparisonofmicrobiologyandvisualoutcomesofpatientsundergoingsmallgaugeand20gaugevitrectomyforendophthalmitis AT chinek comparisonofmicrobiologyandvisualoutcomesofpatientsundergoingsmallgaugeand20gaugevitrectomyforendophthalmitis AT shahss comparisonofmicrobiologyandvisualoutcomesofpatientsundergoingsmallgaugeand20gaugevitrectomyforendophthalmitis AT bakallb comparisonofmicrobiologyandvisualoutcomesofpatientsundergoingsmallgaugeand20gaugevitrectomyforendophthalmitis AT gehrskm comparisonofmicrobiologyandvisualoutcomesofpatientsundergoingsmallgaugeand20gaugevitrectomyforendophthalmitis AT boldthc comparisonofmicrobiologyandvisualoutcomesofpatientsundergoingsmallgaugeand20gaugevitrectomyforendophthalmitis AT russellsr comparisonofmicrobiologyandvisualoutcomesofpatientsundergoingsmallgaugeand20gaugevitrectomyforendophthalmitis AT folkjc comparisonofmicrobiologyandvisualoutcomesofpatientsundergoingsmallgaugeand20gaugevitrectomyforendophthalmitis AT mahajanvb comparisonofmicrobiologyandvisualoutcomesofpatientsundergoingsmallgaugeand20gaugevitrectomyforendophthalmitis
_version_	1718401408990969856

Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis

Ejemplares similares