Immediate Vitrectomy for Acute Endophthalmitis in Patients with a Visual Acuity of Hand Motion or Better

Jaemin Kim; Hyoung Seok Kim; Su Jin Yoo; Moonjung Choi; Youngju Lew; Jong Woo Kim; Han Joo Cho

doi:10.3341/kjo.2022.0014

Immediate Vitrectomy for Acute Endophthalmitis in Patients with a Visual Acuity of Hand Motion or Better

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Type: Academic journal

Author: Jaemin Kim (Konyang University College of Medicine) Hyoung Seok Kim (Konyang University College of Medicine) Su Jin Yoo (Konyang University College of Medicine) Moonjung Choi (건양대학교) Youngju Lew (Konyang University College of Medicine) Jong Woo Kim (Konyang University College of Medicine) Han Joo Cho (Konyang University College of Medicine)

Journal: 대한안과학회 Korean Journal of Ophthalmology Korean Journal of Ophthalmology 제36권 제5호 KCI Accredited Journals

Published: 2022.10

Pages: 390 - 397 (8page)

DOI: 10.3341/kjo.2022.0014

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Immediate Vitrectomy for Acute Endophthalmitis in Patients with a Visual Acuity of Hand Motion or Better

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Purpose: To determine the efficacy of immediate pars plana vitrectomy as the primary treatment for acute endophthalmitisin patients with a visual acuity (VA) of hand motion (HM) or better.Methods: A total of 149 patients who were referred to a single center for acute endophthalmitis after cataract surgery overthe 13-year study period were retrospectively analyzed. Only patients presenting with a VA of at least HM were included. Patientswere initially treated with either primary vitrectomy or intravitreal antibiotic injection alone, and their visual outcomesand reintervention rates after initial treatment were compared.Results: There was no significant difference in the proportion of good (final VA ≥20 / 40) and poor (VA ≤ counting finger)visual outcomes between the groups. However, subgroup analysis of patients with a VA of HM (92 eyes) showed that theincidence of reintervention (14 of 72 eyes [19.4%] vs. 9 of 20 eyes [45.0%]) and poor visual outcomes (10 of 72 eyes [13.9%]vs. 8 of 20 eyes [40.0%]) were lower after prompt vitrectomy than after intravitreal antibiotic injection alone (p = 0.019 andp = 0.022, respectively). For those with a VA of at least counting finger, no significant difference was observed between thegroups.Conclusions: For patients with endophthalmitis presenting with a VA of HM, performing a prompt vitrectomy reduced theincidence of reintervention and poor visual outcomes than the administration of intravitreal antibiotics alone. Our resultssuggest that primary vitrectomy for patients with endophthalmitis presenting with a VA of HM could be more beneficial thanintravitreal antibiotic injection alone.

#Cataract #Endophthalmitis #Phacoemulsification #Visual acuity #Vitrectomy

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