Portable single port 23-gauge vitrectomy in postoperative endophthalmitis

Portable single port 23-gauge vitrectomy in postoperative endophthalmitis

Fabian Höhn,1,* Florian TA Kretz,2,* Saumil Sheth,3 S Natarajan,3 Pankaj Singh,4 Frank H Koch,4 Michael J Koss2,51Helios Klinikum Pforzheim, Pforzheim, Germany; 2Department of Ophthalmology, Hospital of the Ruprecht-Karls University, Heidelberg, Germany; 3Aditya Jyot Eye Hospital Pvt.&n...

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Autores principales: Höhn F, Kretz FT, Sheth S, Natarajan S, Singh P, Koch FH, Koss MJ
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Lenguaje:EN
Publicado: Dove Medical Press 2015
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Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/3f056ebf6cc74d68a78ae88951053fd3
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spelling oai:doaj.org-article:3f056ebf6cc74d68a78ae88951053fd32021-12-02T08:55:23ZPortable single port 23-gauge vitrectomy in postoperative endophthalmitis1177-5483https://doaj.org/article/3f056ebf6cc74d68a78ae88951053fd32015-08-01T00:00:00Zhttp://www.dovepress.com/portable-single-port-23-gauge-vitrectomy-innbsppostoperative-endophtha-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Fabian Höhn,1,* Florian TA Kretz,2,* Saumil Sheth,3 S Natarajan,3 Pankaj Singh,4 Frank H Koch,4 Michael J Koss2,51Helios Klinikum Pforzheim, Pforzheim, Germany; 2Department of Ophthalmology, Hospital of the Ruprecht-Karls University, Heidelberg, Germany; 3Aditya Jyot Eye Hospital Pvt. Ltd, Mumbai, India; 4Department of Ophthalmology, Hospital of the Goethe University, Frankfurt am Main, Germany; 5Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA*These authors contributed equally to this workAim: To evaluate the safety and effectiveness of the Intrector® for treating postoperative endophthalmitis.Materials and methods: In a retrospective multicenter study, patients who received a single port 23-gauge core pars plana vitrectomy and isovolumetric injection of vancomycin, ceftazidime, and dexamethasone/amphotericin B using the Intrector® for postoperative endophthalmitis of intermediate severity (grade II or III vitreous inflammation and best-corrected visual acuity between hand movements and 0.3 logMAR [logarithm of the minimum angle of resolution]) were evaluated. Improvement in visual acuity, resolution of intraocular inflammation, the need for additional surgical procedures, and the development of complications were evaluated at a 1-month follow-up examination.Results: Fifteen patients (mean age 55.6±7.2 years) underwent treatment with the Intrector®. The mean vitreous volume aspirated was 0.78±0.22 mL. The vitreous samples indicated positive microorganism culture results in six of the 15 cases, but the samples were positive when analyzed by real-time polymerase chain reaction in all cases (15/15). The mean best-corrected visual acuity improved significantly (P=0.01) from 0.88±0.29 (logMAR) to 0.32±0.28. Each patient demonstrated at least three lines of visual improvement. No additional medical or surgical interventions were required, and the complete resolution of intraocular inflammation was noted in all patients at the 1-month follow-up examination. No procedure-related complications were observed.Conclusion: The Intrector® may be a safe and effective treatment option for infectious postoperative endophthalmitis. Larger studies comparing the outcomes of the Intrector® to the traditional treatments for postoperative endophthalmitis need to be conducted before its role in the treatment of postoperative endophthalmitis can be properly defined.Keywords: Intrector®, postoperative endophthalmitis, 23-gauge vitrectomyHöhn FKretz FTSheth SNatarajan SSingh PKoch FHKoss MJDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 1457-1461 (2015)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Höhn F
Kretz FT
Sheth S
Natarajan S
Singh P
Koch FH
Koss MJ
Portable single port 23-gauge vitrectomy in postoperative endophthalmitis
description Fabian Höhn,1,* Florian TA Kretz,2,* Saumil Sheth,3 S Natarajan,3 Pankaj Singh,4 Frank H Koch,4 Michael J Koss2,51Helios Klinikum Pforzheim, Pforzheim, Germany; 2Department of Ophthalmology, Hospital of the Ruprecht-Karls University, Heidelberg, Germany; 3Aditya Jyot Eye Hospital Pvt. Ltd, Mumbai, India; 4Department of Ophthalmology, Hospital of the Goethe University, Frankfurt am Main, Germany; 5Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA*These authors contributed equally to this workAim: To evaluate the safety and effectiveness of the Intrector® for treating postoperative endophthalmitis.Materials and methods: In a retrospective multicenter study, patients who received a single port 23-gauge core pars plana vitrectomy and isovolumetric injection of vancomycin, ceftazidime, and dexamethasone/amphotericin B using the Intrector® for postoperative endophthalmitis of intermediate severity (grade II or III vitreous inflammation and best-corrected visual acuity between hand movements and 0.3 logMAR [logarithm of the minimum angle of resolution]) were evaluated. Improvement in visual acuity, resolution of intraocular inflammation, the need for additional surgical procedures, and the development of complications were evaluated at a 1-month follow-up examination.Results: Fifteen patients (mean age 55.6±7.2 years) underwent treatment with the Intrector®. The mean vitreous volume aspirated was 0.78±0.22 mL. The vitreous samples indicated positive microorganism culture results in six of the 15 cases, but the samples were positive when analyzed by real-time polymerase chain reaction in all cases (15/15). The mean best-corrected visual acuity improved significantly (P=0.01) from 0.88±0.29 (logMAR) to 0.32±0.28. Each patient demonstrated at least three lines of visual improvement. No additional medical or surgical interventions were required, and the complete resolution of intraocular inflammation was noted in all patients at the 1-month follow-up examination. No procedure-related complications were observed.Conclusion: The Intrector® may be a safe and effective treatment option for infectious postoperative endophthalmitis. Larger studies comparing the outcomes of the Intrector® to the traditional treatments for postoperative endophthalmitis need to be conducted before its role in the treatment of postoperative endophthalmitis can be properly defined.Keywords: Intrector®, postoperative endophthalmitis, 23-gauge vitrectomy
format article
author Höhn F
Kretz FT
Sheth S
Natarajan S
Singh P
Koch FH
Koss MJ
author_facet Höhn F
Kretz FT
Sheth S
Natarajan S
Singh P
Koch FH
Koss MJ
author_sort Höhn F
title Portable single port 23-gauge vitrectomy in postoperative endophthalmitis
title_short Portable single port 23-gauge vitrectomy in postoperative endophthalmitis
title_full Portable single port 23-gauge vitrectomy in postoperative endophthalmitis
title_fullStr Portable single port 23-gauge vitrectomy in postoperative endophthalmitis
title_full_unstemmed Portable single port 23-gauge vitrectomy in postoperative endophthalmitis
title_sort portable single port 23-gauge vitrectomy in postoperative endophthalmitis
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/3f056ebf6cc74d68a78ae88951053fd3
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AT natarajans portablesingleport23gaugevitrectomyinnbsppostoperativeendophthalmitis
AT singhp portablesingleport23gaugevitrectomyinnbsppostoperativeendophthalmitis
AT kochfh portablesingleport23gaugevitrectomyinnbsppostoperativeendophthalmitis
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