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International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis

2019; Elsevier BV; Volume: 3; Issue: 6 Linguagem: Inglês

10.1016/j.oret.2019.03.009

2468-7219

Mohamed Kamel Soliman, Giampoalo Gini, Ferenc Kuhn, Mariano Irós, Barbara Parolini, Şengül Özdek, Zofia Michalewska, Silvia Bopp, Ron A. Adelman, Ahmed B. Sallam, Agnieszka Kardaszewska, Alain Nazaire M’Bongo Zindamoyen, Alay Banker, Andrii Serhiienko, Angela Loo, Meireles Angelina, Bahri Aydın, Britta Luebke, Cüneyt Özmen, Dominik Odrobina, Enrico Bertelli, Erkan Ünsal, F Roberts Kenneth, F. Becquet, F. Hamon, Giacomo Pellegrini, Gian Marco Tosi, Giuseppe Donvito, Hussain Ahmad Khaqan, Idriss Badat, Ivan Fišer, Janusz Michalewski, J F Le Rouic, Jerzy Nawrocki, J. Zarallo-Gallardo, Jugn Ho Lee, Karolina Bonińska, Katarzyna Nowomiejska, K Dziegielewski, Luis Arrevola-Velasco, Lyubomyr Lytvynchuk, Maha Elshafei, Pietras-Trzpiel Malgorzata, Mariano Irós, Martin Detjen, Matías Iglicki, Matteo Badino, Meireles Angelina, Mikhail Gavura, Murat Hasanreisoğlu, Mustafa Karadaş, Narciso Atienza, Nur Acar, Ogugua Ndubuisi Okonkwo, Peter Miesbauer, Pietras-Trzpiel Malgorzata, Raúl Vélez-Montoya, R. Standen Robert, Rino Frisina, Rita Soyeur, Robert Ręjdak, Roberta Giannini, Sangeet Mittal, Shohista Saidkasimova, Shuaib Abdulsalam, Sławomir Cisiecki, Štěpán Rušňák, Stephen C. Teoh, Susana Teixeira, Tuğrul Altan, Wolfgang Schrader, Zia Kapran, Zeynep Aktaş, Zsuzsanna Szijártó,

Ocular Diseases and Behçet’s Syndrome

To study the practice patterns for the management of acute postoperative and postinjection endophthalmitis. Retrospective, interventional, nonrandomized, multicenter study. Data on 237 eyes diagnosed with acute endophthalmitis occurring after intraocular surgery or procedures provided by 57 retina specialists from 28 countries. Rates of pars plana vitrectomy (PPV), repeat intravitreal injection, and adjunctive therapeutic regimens (local and systemic antibiotics and steroids). Of 237 analyzed eyes, acute endophthalmitis secondary to cataract surgery or secondary lens implantation represented 64.6% of cases (153 eyes), whereas the remaining were secondary to intravitreal injections (35 eyes [14.8%]), PPV (29 eyes [12.2%]), and other intraocular surgeries (20 eyes [8.4%]). All eyes received intravitreal antibiotics on the same day of diagnosis. Overall, early PPV was used within the first week of presentation in 176 eyes (74.3%). There was no statistical difference in the proportion of eyes requiring a second intravitreal injection of antibiotics whether the eye was managed primarily with intravitreal antibiotics alone versus early PPV plus intravitreal antibiotics (29.5% [18 eyes] vs. 25.0% [44 eyes], respectively). Adjunctive therapies in the form of intravitreal steroids, systemic steroids, and systemic antibiotics were used in 25.3%, 21.9%, and 66.6% of eyes, respectively. The absence of disc or macular view and absence of endophthalmitis after cataract surgery were associated with an increased likelihood for early PPV (odds ratios 4.1 and 5.1, respectively). Pars plana vitrectomy was frequently performed regardless of the presenting vision in eyes with endophthalmitis after cataract surgery and intravitreal injections. Increased vitreous opacification was associated with a higher probability for performing PPV.