Prognostic factors associated with the visual outcome after vitrectomy for endophthalmitis
Tóm tắt
• Background: Functional results following vitrectomy with intraocular and systemic antibiotic treatment for endophthalmitis are influenced by numerous factors. • Methods: A retrospective study of 65 cases of endophthalmitis treated between October 1988 and May 1994 at the Department of Ophthalmology, University of Cologne, Germany was conducted. All eyes underwent pars plana vitrectomy and intraocular and systemic antibiotic treatment. • Results: Vision of 20/400 or better could be obtained in 66% of eyes following extracapsular cataract extraction and intraocular lens implantation (ECCE + IOL), in 62% after severe eye injury, in 36% of eyes after intraocular surgery for other reasons than cataract extraction with lens implantation and in 33% of patients with endogenous endophthalmitis. Vision of 20/50 or better could be achieved in 41% of eyes following ECCE + IOL and additional systemic steroid treatment. In 22% of cases primary silicone endotamponade was performed; 57% of these eyes obtained visual acuity of 20/400 or better. Fifteen patients (23%) suffered diabetes mellitus; 20/400 vision or better could be achieved in 73% of these eyes. Visual acuity of hand movements or better before vitrectomy was associated with 20/400 vision or better in 69% of cases, whereas ambulatory vision could be attained in only 33% of patients with visual acuity of worse than hand movements at the initial presentation. Visual acuity of less than 20/400 was found in all eyes with haemolytic streptococcal infections. • Conclusion: Prompt treatment of endophthalmitis is crucial. Additional treatment using systemic steroids and, if necessary, silicone oil can improve the functional outcome in some cases.
Tài liệu tham khảo
citation_journal_title=Ophthalmology; citation_title=Microbial endophthalmitis resulting from ocular trauma; citation_author=JC Affeldt, HW Flynn, RK Forster, S Mandelbaum, JG Clarkson, GD Jarus; citation_volume=94; citation_publication_date=1987; citation_pages=407-413; citation_id=CR1
citation_journal_title=Ophthalmology; citation_title=Prevention of postoperative endophthalmitis; citation_author=HF Allen; citation_volume=85; citation_publication_date=1978; citation_pages=386-389; citation_id=CR2
citation_journal_title=Am J Ophthalmol; citation_title=Factors associated with a poor visual result in endophthalmitisz; citation_author=GM Bohigian, RJ Olk; citation_volume=101; citation_publication_date=1986; citation_pages=332-341; citation_id=CR3
citation_journal_title=Arch Ophthalmol; citation_title=Posttraumatic endophthalmitis; citation_author=GS Brinton, TM Topping, RA Hyndiuk, TM Aaberg, FH Reeser, GW Abrams; citation_volume=102; citation_publication_date=1984; citation_pages=547-550; citation_id=CR4
citation_journal_title=Arch Ophthalmol; citation_title=Vitrectomy in endophthalmitis. Results of study using vitrectomy, intraocular antibiotics, or a combination of both; citation_author=AJ Cottingham, RK Forster; citation_volume=94; citation_publication_date=1976; citation_pages=2078-2081; citation_id=CR5
citation_journal_title=Br J Ophthalmol; citation_title=Panophthalmitis due to an organism of theBacillus subtilis group; citation_author=R Davenport, C Smith; citation_volume=36; citation_publication_date=1952; citation_pages=389-392; citation_id=CR6
citation_journal_title=Arch Ophthalmol; citation_title=Intraocular management of endophthalmitis. A systematic approach; citation_author=JG Diamond; citation_volume=99; citation_publication_date=1981; citation_pages=96-99; citation_id=CR7
citation_journal_title=Arch Ophthalmol; citation_title=The endophthalmitis vitrectomy study (editorial); citation_author=BH Doft; citation_volume=109; citation_publication_date=1991; citation_pages=487-489; citation_id=CR8
citation_journal_title=Retina; citation_title=Treatment of endophthalmitis after cataract extraction; citation_author=BH Doft, SF Kelsey, S Wisniewski, DJ Metz, L Lobes, J Rinkoff, M Davis, A Kassoff; citation_volume=14; citation_publication_date=1994; citation_pages=297-304; citation_id=CR9
citation_journal_title=Am J Ophthalmol; citation_title=Further observations on the diagnosis, cause, and treatment of endophthalmitis; citation_author=RK Forster, IG Zachary, AJ Cottingham, EW Norton; citation_volume=81; citation_publication_date=1976; citation_pages=52-56; citation_id=CR10
citation_journal_title=Aust J Ophthalmol; citation_title=Vitrectomy in the management of endophthalmitis; citation_author=OB Hadden; citation_volume=9; citation_publication_date=1981; citation_pages=27-32; citation_id=CR11
Hida T, Yano K, Ohyama M (1994)Candida endophthalmitis in patients recieving intravenous hyperalimentation. Abstract Book of the XIXth meeting of the Club Jules Gonin, abstract
citation_journal_title=Ophthalmology; citation_title=Nosocomial endophthalmitis survey. Current incidence of infection after intraocular surgery; citation_author=HM Kattan, HW Flynn, SC Pflugfelder, C Robertson, RK Forster; citation_volume=98; citation_publication_date=1991; citation_pages=227-238; citation_id=CR13
citation_journal_title=Int Ophthalmol Clin; citation_title=Endophthalmitis associated with filtering blebs; citation_author=S Mandelbaum, RK Forster; citation_volume=27; citation_publication_date=1987; citation_pages=107-111; citation_id=CR14
citation_journal_title=Ophthalmology; citation_title=Late onset endophthalmitis associated with filtering blebs; citation_author=S Mandelbaum, RK Forster, H Gelender, W Culbertson; citation_volume=92; citation_publication_date=1985; citation_pages=964-972; citation_id=CR15
citation_journal_title=Arch Ophthalmol; citation_title=Endophthalmitis caused by streptococcal species; citation_author=LK Mao, HW Flynn, D Miller, SC Pflugfelder; citation_volume=110; citation_publication_date=1992; citation_pages=798-801; citation_id=CR16
citation_journal_title=Ophthalmology; citation_title=Retinal detachment following endophthalmitis; citation_author=PT Nelsen, DA Marcus, JA Bovino; citation_volume=92; citation_publication_date=1985; citation_pages=1112-1117; citation_id=CR17
citation_journal_title=Ophthalmology; citation_title=Results in the treatment of postoperative endophthalmitis; citation_author=JC Olson, HW Flynn, RK Forster, WW Culbertson; citation_volume=90; citation_publication_date=1983; citation_pages=692-699; citation_id=CR18
citation_journal_title=Ophthalmology; citation_title=Infectious endophthalmitis. Review of 36 cases; citation_author=CA Puliafito, AS Baker, J Haaf, CS Foster; citation_volume=89; citation_publication_date=1982; citation_pages=921-929; citation_id=CR19
citation_journal_title=N Engl J Med; citation_title=Bacterial meningitis: pathogenesis, pathophysiology, and progress; citation_author=V Quagliarello, WM Scheld; citation_volume=327; citation_publication_date=1992; citation_pages=864-872; citation_id=CR20
citation_journal_title=Can J Ophthalmol; citation_title=Clindamycin-resistantBacillus endophthalmitis; citation_author=TK Sakamoto, AF Cruess, DE Zoutman, GA Evans; citation_volume=28; citation_publication_date=1993; citation_pages=339-342; citation_id=CR21
citation_journal_title=Surv Ophthalmol; citation_title=Antimicrobial prophylaxis for ophthalmic surgery; citation_author=MB Starr, JM Lally; citation_volume=39; citation_publication_date=1995; citation_pages=485-501; citation_id=CR22