scholarly journals Exogenous Endophthalmitis in Diabetic Patients: A Systemic Review

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Georges M. El-Mollayess ◽  
Joanna S. Saadeh ◽  
Haytham I. Salti
Keyword(s):  
Pars Plana Vitrectomy ◽  
Systemic Disease ◽  
Bacterial Flora ◽  
Cataract Extraction ◽  
Systemic Review ◽  
Inflammatory Factors ◽  
Diabetic Patients ◽  
Hand Motion ◽  
Pars Plana ◽  
Exogenous Endophthalmitis

Diabetes mellitus is a systemic disease that increases the risk of infections. Exogenous endophthalmitis is an inflammatory disease to which diabetic patients are more predisposed to than nondiabetic patients undergoing any intraocular intervention. This might be because of the change in the immune and inflammatory factors that intervene in wound healing and in the bacterial flora of the ocular adnexa. We conducted a literature review to assess the risk of exogenous endophthalmitis in diabetic patients undergoing cataract extraction, pars plana vitrectomy, and intravitreal injections and to check whether its treatment differ from in non-diabetics. We found that diabetic patients are more predisposed to virulent organisms and that the incidence of ophthalmic symptoms was not substantially different in diabetic versus nondiabetic patients. Regarding treatment, all patients with light perception should receive pars plana vitrectomy, while those with hand motion and better vision should be given an intravitreal antibiotics injection. Some authors recommend vitrectomy to diabetic patients with even counting figure vision.

scholarly journals Visual outcome and complications of cataract extraction after pars plana vitrectomy

2018 ◽  
Vol Volume 12 ◽  
pp. 989-994 ◽  
Author(s):  
Amanda Rey ◽  
Ignasi Jürgens ◽  
Xavier Maseras ◽  
Agnieszka Dyrda ◽  
Patricia Pera ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Visual Outcome ◽  
Cataract Extraction ◽  
Pars Plana

scholarly journals The serious eye inflammation of post intraocular Avastin injection

2020 ◽  
Vol 3 (2) ◽  
pp. 01-06
Author(s):  
Fathy Abdolmejed ◽  
Khalid Almajri ◽  
Ghamela Ali
Keyword(s):  
Pars Plana Vitrectomy ◽  
Statistical Study ◽  
Medical Center ◽  
Systemic Disease ◽  
Management Strategies ◽  
Causative Organism ◽  
P Value ◽  
Coagulase Negative Staphylococci ◽  
Treatment Protocols ◽  
Pars Plana

Retrospective statistical study a collection of all patients with post intra vitreal injection (IVI) endophthalmitis in last 10 year period between 2010–2019 in eye department of Tobruk medical center -Tobruk and eye department of Alwahda hospital - Derna. We aim in this study to review the microbiology, clinical characteristics, diagnosis, and management strategies of post-intra vitreal injection endophthalmitis, by comparing our results with the different studies designs and treatment protocols. There were 9 patients of the after intra vitreal injections endophthalmitis cases. The age average is 70 years, 6 cases are females and 3 casees are male, all of them were practice post intravitreal Avastin injection endophthalmitis. There were 8 patients had Diabetes mellitus (DM), 2 patients had cardiovascular disease and 1 patient had hepatitis C as a systemic disease. The most common causative organism after intra vitreous injection endophthalmitis is Coagulase-negative staphylococci (CNS) 100% from the 56% positive causative organisms and 44% are no detected microorganisms, the outcome of cases which managed with pars-plana-vitrectomy (PPV) improved significantly about 60 Letters (> 3 Lines) and cases managed without PPV > 15 Letters (> 3 Lines). The cases of post intraocular endophthalmitis which diagnosed and treated early with PPV give a good result and can save the vision. The cases of acute POE in the first 3 day had significant better function (P value = 0.02).

scholarly journals Pars Plana Vitrectomy and the Risk of Ocular Hypertension and Glaucoma: Where Are We?

2020 ◽  
Vol 9 (12) ◽  
pp. 3994
Author(s):  
Tommaso Rossi ◽  
Guido Ripandelli
Keyword(s):  
Anterior Chamber ◽  
Ocular Hypertension ◽  
Oxygen Tension ◽  
Pars Plana Vitrectomy ◽  
Open Angle Glaucoma ◽  
Crystalline Lens ◽  
Cataract Extraction ◽  
Oxygen Scavenger ◽  
Clinical Series ◽  
Pars Plana

Purpose is to review the pathogenic mechanism for ocular hypertension and glaucoma development after pars plana vitrectomy. Both acute and chronic causes are considered, and special attention is paid to the theories and clinical evidence on the risk of developing Open Angle Glaucoma (OAG) after Pars Plana Vitrectomy (PPV). Most existing scientific literature on the issue agree on the role of ascorbate as an oxygen scavenger within the vitreous chamber. Oxygen tension in the vitreous and anterior chamber is maximum inn proximity of the retinal surface and endothelium, respectively and steeply decreases toward the lens, on both sides, and trabecular meshwork. Vitreous removal and, to a lesser extent, liquefaction, greatly reduces oxygen tension gradient in vitreous chamber while cataract extraction has similar effects on anterior chamber oxygen gradients. Oxygen derivatives originated from the cornea and retina are actively reduced by the vitreous gel and/or the crystalline lens. Vitreous removal and cataract extraction reduce drastically this function. Most reported clinical series confirm this hypothesis although protocol difference and follow-up length greatly impact the reliability of results.

Vitreoretinal Surgery in Diabetic Patients on Hemodialysis

1997 ◽  
Vol 7 (3) ◽  
pp. 283-287 ◽  
Author(s):  
J. Nawrocki ◽  
W. Chrzanowski ◽  
D. Koch ◽  
K. Dziegielewski
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Type I Diabetes ◽  
Vitreoretinal Surgery ◽  
Final Visual Acuity ◽  
Diabetic Patients ◽  
Type I ◽  
First Results ◽  
Pars Plana

The present paper reports our first results after pars plana vitrectomy in patients with diabetic retinopathy and hemodialysis with a follow-up of 6 to 24 months. Between January 1992 and October 1994 we performed vitreoretinal surgery with silicone oil tamponade in nine eyes of seven patients with diabetic nephropathy on hemodialysis. All patients had had type I diabetes for 19–32 years. Over the observation period the retina was completely attached in eight eyes. Final visual acuity of 0.1 - 0.7 was attained in four eyes, 0.06 two, hand movements in one eye. Two eyes had no useful final visual acuity because of redetachment of the retina or secondary glaucoma with rubeosis iridis. The small number of complications shows that pars plana vitrectomy can be done in diabetic patients with nephropathy on hemodialysis. This significantly improves their quality of life

Choice of Surgical Technique in the Management of Cataract Combined with Vitreous Surgery

1997 ◽  
Vol 7 (3) ◽  
pp. 245-250 ◽  
Author(s):  
D. De Ortueta Hilberath ◽  
C.C. Lösche
Keyword(s):  
Pars Plana Vitrectomy ◽  
Corneal Edema ◽  
Cataract Extraction ◽  
Posterior Segment ◽  
Combined Surgery ◽  
Vitreous Surgery ◽  
Choice Of Procedure ◽  
Scleral Tunnel ◽  
Pars Plana Lensectomy ◽  
Pars Plana

Purpose. To compare different methods of lens removal during vitreous surgery. Methods. We reviewed the data of 37 consecutive eye operations with combined surgery of the lens and vitreous in the Mülheim Eye Hospital between March ‘93 and September ‘94. Results. In 14 eyes a pars plana lensectomy was done, in 7 an ECCE (extra capsular cataract extraction), and in 16 phacoemulsification was combined with a regular threeport pars plana vitrectomy. Conclusions. The choice of procedure was mainly influenced by the hardness of the lens and whether an IOL implant was considered. If no IOL is planned and the lens is soft enough, the best way to remove it is by pars plana lensectomy. If the nucleus seems too hard, phacoemulsification should be performed, because of the risk of releasing the nucleus into the posterior segment. If an IOL is planned, the best method of lens removal is phacoemulsification via a scleral tunnel. In both cases if the nucleus is very hard ECCE should be performed because of the risk of corneal edema.

scholarly journals Clinical Analysis of Persistent Subretinal Fluid after Pars Plana Vitrectomy in Macula with Diabetic Tractional Retinal Detachment

2021 ◽  
Vol 10 (24) ◽  
pp. 5929
Author(s):  
Yong-Koo Kang ◽  
Jae-Pil Shin
Keyword(s):  
Retinal Detachment ◽  
Kidney Function ◽  
Pars Plana Vitrectomy ◽  
Univariate Analysis ◽  
Subretinal Fluid ◽  
Clinical Analysis ◽  
Diabetic Patients ◽  
Contributing Factors ◽  
Tractional Retinal Detachment ◽  
Pars Plana

(1) Background: We analyzed the duration of persistent subretinal fluid (PSF) and the contributing factors of PSF after pars plana vitrectomy in patients who had a macula with diabetic tractional retinal detachment (TRD). (2) Methods: Forty eyes of 40 patients who had pars plana vitrectomy due to a macula with diabetic TRD, between 2014 and 2020, were retrospectively reviewed. The duration of PSF, as well as relevant ocular and systemic factors, was analyzed. (3) Results: The mean duration of PSF was 4.4 ± 4.7 months. The prevalence of PSF was 75.0% at 1 month, 50.0% at 3 months, 30.0% at 6 months and 10.0% at 12 months after surgery. Blood urea nitrogen, creatinine, and estimated glomerular filtration rate (eGFR) were significantly associated with the duration of PSF in the univariate analysis. In the multivariate analysis, only eGFR was significantly associated with the duration of PSF (β = −0.089, p = 0.030). (4) Conclusion: PSF may persist for more than 12 months in a macula with diabetic TRD after vitrectomy. Moreover, patients with impaired kidney function tended to have a delayed subretinal fluid absorption. Therefore, careful investigation of preoperative systemic conditions, especially kidney function, should be considered before TRD surgery in diabetic patients.

scholarly journals Intravitreal Daptomycin for Recalcitrant Postoperative Endophthalmitis

2016 ◽  
Vol 7 (1) ◽  
pp. 103-107 ◽  
Author(s):  
Jennifer M. Sim ◽  
Kapil G. Kapoor ◽  
Alan L. Wagner
Keyword(s):  
Pars Plana Vitrectomy ◽  
Vancomycin Resistance ◽  
Occurrence Rate ◽  
Postoperative Endophthalmitis ◽  
First Case ◽  
Pars Plana ◽  
Exogenous Endophthalmitis ◽  
Postoperative Findings ◽  
Negative Conclusion ◽  
Culture Negative

Purpose: To report the first case to our knowledge of intravitreal daptomycin used to successfully treat culture-negative vancomycin resistant to exogenous endophthalmitis. Methods: Case report with preoperative, intraoperative, and postoperative findings. Results: A 63-year-old Caucasian male underwent routine pars plana vitrectomy with epiretinal membrane peeling. He developed acute postoperative endophthalmitis, and underwent vitreous tap and injection of intravitreal vancomycin/ceftazidime/dexamethasone. Gram stain showed Gram-positive cocci, but cultures were negative. His infection subsequently proved very recalcitrant and his treatment course involved pars plana vitrectomy with anterior chamber washout and repeat injection of antibiotics, followed by repeat intravitreal vancomycin and ceftazidime. Ultimately, a second vitrectomy with intravitreal daptomycin controlled his intraocular infection. On each occasion, cultures were negative. Conclusion: This case suggests that vancomycin resistance should be considered in culture-negative postoperative endophthalmitis, and intravitreal daptomycin should be considered as an important treatment alternative. Although vancomycin resistance is fairly rare in endophthalmitis, acknowledgment of its increasing occurrence rate is critical for optimal management.

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