Outcome of 23gauge sutureless transconjunctival vitrectomy for endophthalmitis - PowerPoint PPT Presentation

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Outcome of 23gauge sutureless transconjunctival vitrectomy for endophthalmitis

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Outcome of 23-gauge sutureless transconjunctival vitrectomy for ... Dr Francine YANG. Dr ... Vitrectomy may be useful in treatment of endophthalmitis, ... – PowerPoint PPT presentation

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Title: Outcome of 23gauge sutureless transconjunctival vitrectomy for endophthalmitis


1
Outcome of 23-gauge sutureless transconjunctival
vitrectomy for endophthalmitis
  • Dr Colin S.H. Tan

2
Acknowledgments
  • Dr Hon Kiat WONG
  • Dr Francine YANG
  • Dr Jong Jian LEE
  • The authors have no financial or proprietary
    interests in the subject of this poster

3
Introduction
  • Endophthalmitis is a potentially devastating eye
    infection
  • Postoperative endophthalmitis reported in between
    0.04 to 0/12 of cases
  • Vitrectomy may be useful in treatment of
    endophthalmitis, especially with visual acuity of
    light perception or worse.
  • No previous report on use of 23-G sutureless
    vitrectomy to treat endophthalmitis

4
Objectives
  • To review the feasibility and surgical outcomes
    of using 23G transconjunctival vitrectomy for the
    treatment of endophthalmitis

5
Methods
  • Non-randomized, interventional case series study
  • All patients presenting with postoperative
    endophthalmitis over a 1-year period from April
    2005 to March 2006
  • Main outcome measures intraoperative and
    posteroperative complications (hypotony, wound
    leak, chemosis)

6
Results
  • Vitrectomy was performed on 6 patients (4 acute
    and 2 chronic endophthalmitis)
  • Mean surgical time 58.3 minutes (range 40 75)
  • Mean follow-up 13.2 months (range, 9 17)

7
Surgical outcomes
  • Thorough clearance of the vitreous base was
    achieved
  • No severe postoperative pain
  • No wound leak / hypotony
  • Mean IOP on 1st postoperative day was 17.3 mmHg
    (SD ? 3.4, range, 12 21 mmHg)
  • Mean IOP change -4.2 mmHg compared to the
    preoperative IOP (p0.239)

8
Visual outcomes
  • 20/40 in 5 of 6 patients (83.3) overall
  • 20/40 in 3 of 4 patients (75) with acute
    endophthalmitis
  • Final visual acuity (VA) significantly improved
    compared to preoperative VA (p0.026)

9
Characteristics of patients
10
Discussion
  • Advantages of transconjunctival vitrectomy
  • Reduced surgical time
  • Less postoperative discomfort
  • Shorter recovery time
  • Concern about postoperative hypotony due to
    sutureless sclerostomy
  • Able to clear vitreous base without difficulty
    using 23-gauge instruments

11
Conclusion
  • 23-gauge transconjunctival vitrectomy can be
    performed safely for both acute and chronic
    endophthalmitis
  • Good final visual acuity
  • No cases of hypotony or severe complications
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