Management of endophthalmitis while preserving the uninvolved crystalline lens

Justin Townsend, Avinash Pathengay, Harry W Flynn Jr, Darlene MillerDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USABackground: The purpose of this work is to report on the management of endophthalmitis in phakic eyes in which t...

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Autores principales:	Townsend J, Pathengay A, Flynn Jr HW, Miller D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/4952f971831b4ef39273e757c94e3709
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spelling	oai:doaj.org-article:4952f971831b4ef39273e757c94e37092021-12-02T09:04:24ZManagement of endophthalmitis while preserving the uninvolved crystalline lens1177-54671177-5483https://doaj.org/article/4952f971831b4ef39273e757c94e37092012-03-01T00:00:00Zhttp://www.dovepress.com/management-of-endophthalmitis-while-preserving-the-uninvolved-crystall-a9519https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Justin Townsend, Avinash Pathengay, Harry W Flynn Jr, Darlene MillerDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USABackground: The purpose of this work is to report on the management of endophthalmitis in phakic eyes in which the crystalline lens was preserved.Methods: The current study is a noncomparative consecutive case series of patients who developed culture-proven endophthalmitis and were treated between January 1995 and June 2009. The study included only phakic patients whose infection was managed without removal of the crystalline lens. Using a computerized search of Microbiology Department records, patients were identified with phakic lens status and clinically diagnosed endophthalmitis.Results: A total of 12 phakic eyes from 11 patients met the study criteria. The etiology of infection was endogenous (n = 6), postoperative (n = 5), and post-traumatic (n = 1). Pars plana vitrectomy and injection of intravitreal antimicrobials was performed in seven eyes (58%), and vitreous tap and injection of antimicrobials was performed in five eyes (42%). All eyes showed progression of lens opacification after treatment. Overall, nine (75%) achieved visual acuity outcomes &ge;20/80, including five of seven (71%) eyes treated with vitrectomy and four of five eyes (80%) treated with injection of antibiotics alone. One of seven eyes (14%) treated with vitrectomy had a poor visual outcome (defined as &lt;20/400) compared with one of five (20%) eyes treated with intravitreal antimicrobials alone. During follow-up, all 12 eyes had progression of lens opacification and five of 12 (42%) eyes underwent cataract surgery with posterior chamber intraocular lens placement.Conclusion: In phakic patients, successful treatment of endophthalmitis can be achieved while preserving the uninvolved crystalline lens. Future cataract surgery with posterior chamber intraocular lens placement can be accomplished in many of these patients.Keywords: phakic eyes, cataract surgery, intraocular, intravitrealTownsend JPathengay AFlynn Jr HWMiller DDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 453-457 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Townsend J Pathengay A Flynn Jr HW Miller D Management of endophthalmitis while preserving the uninvolved crystalline lens
description	Justin Townsend, Avinash Pathengay, Harry W Flynn Jr, Darlene MillerDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USABackground: The purpose of this work is to report on the management of endophthalmitis in phakic eyes in which the crystalline lens was preserved.Methods: The current study is a noncomparative consecutive case series of patients who developed culture-proven endophthalmitis and were treated between January 1995 and June 2009. The study included only phakic patients whose infection was managed without removal of the crystalline lens. Using a computerized search of Microbiology Department records, patients were identified with phakic lens status and clinically diagnosed endophthalmitis.Results: A total of 12 phakic eyes from 11 patients met the study criteria. The etiology of infection was endogenous (n = 6), postoperative (n = 5), and post-traumatic (n = 1). Pars plana vitrectomy and injection of intravitreal antimicrobials was performed in seven eyes (58%), and vitreous tap and injection of antimicrobials was performed in five eyes (42%). All eyes showed progression of lens opacification after treatment. Overall, nine (75%) achieved visual acuity outcomes &ge;20/80, including five of seven (71%) eyes treated with vitrectomy and four of five eyes (80%) treated with injection of antibiotics alone. One of seven eyes (14%) treated with vitrectomy had a poor visual outcome (defined as &lt;20/400) compared with one of five (20%) eyes treated with intravitreal antimicrobials alone. During follow-up, all 12 eyes had progression of lens opacification and five of 12 (42%) eyes underwent cataract surgery with posterior chamber intraocular lens placement.Conclusion: In phakic patients, successful treatment of endophthalmitis can be achieved while preserving the uninvolved crystalline lens. Future cataract surgery with posterior chamber intraocular lens placement can be accomplished in many of these patients.Keywords: phakic eyes, cataract surgery, intraocular, intravitreal
format	article
author	Townsend J Pathengay A Flynn Jr HW Miller D
author_facet	Townsend J Pathengay A Flynn Jr HW Miller D
author_sort	Townsend J
title	Management of endophthalmitis while preserving the uninvolved crystalline lens
title_short	Management of endophthalmitis while preserving the uninvolved crystalline lens
title_full	Management of endophthalmitis while preserving the uninvolved crystalline lens
title_fullStr	Management of endophthalmitis while preserving the uninvolved crystalline lens
title_full_unstemmed	Management of endophthalmitis while preserving the uninvolved crystalline lens
title_sort	management of endophthalmitis while preserving the uninvolved crystalline lens
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/4952f971831b4ef39273e757c94e3709
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Management of endophthalmitis while preserving the uninvolved crystalline lens

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