Pars plana vitrectomy with or without silicone oil endotamponade in post-traumatic endophthalmitis.
BACKGROUND
Results of core vitrectomy in post-traumatic endophthalmitis are poor. Our initial results of complete vitrectomy with primary silicone oil endotamponade were promising. A comparative study of this procedure with conventional core vitrectomy was therefore carried out.


METHODS
A prospective randomized controlled study of 24 consecutive cases of post-traumatic endophthalmitis was conducted. Patients were randomized into two groups in the absence of clinical improvement after primary tap and treatment with intravitreal vancomycin and amikacin: group 1 consisted of patients who underwent core vitrectomy alone, group 2 of patients who underwent complete vitrectomy with silicone oil endotamponade. All patients included in the study received intravenous antibiotics and underwent lensectomy. Patients were followed up 1, 2, 4 and 12 weeks postoperatively. In all patients of group 2, silicone oil was removed 6 weeks after primary surgery. The mean duration of follow-up was 112+/-55 days.


RESULTS
Vision of 20/400 or better was obtained in 58.33% of cases (14/24). Visual acuity of only one patient in group 1 was >or=20/200, compared with that of 58.3% of patients (7/12) in group 2 ( P=0.02). Intra-operative retinal breaks were found in 50% (6/12) of the patients belonging to group 1, but did not affect the final visual outcome. In group 1, 33.33% (4/12) developed rhegmatogenous retinal detachment in the immediate post-operative period. Only one of these patients had useful final visual outcome after resurgery.


CONCLUSIONS
Complete vitrectomy with primary silicone oil endotamponade is a useful treatment modality which improves the anatomical and functional results in post-traumatic endophthalmitis.
Azad
Rajvardhan
R
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Ravi
Keshavamurthy
K
Talwar
Dinesh
D
Rajpal
Kumar
Neena
N
D000293:Adolescent; D000328:Adult; D002648:Child; D009877:Endophthalmitis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D005131:Eye Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011184:Postoperative Period; D012086:Reoperation; D012163:Retinal Detachment / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D012167:Retinal Perforations / Q000150:complications / Q000453:epidemiology / Q000209:etiology; D012827:Silicone Oils / Q000009:adverse effects / Q000627:therapeutic use*; D014785:Vision, Ocular; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods
D012827:Silicone Oils