[Endophthalmitis following new procedures].
New procedures such as intravitreal injections, 25-G or 23-G vitrectomies, and intravitreal implantations are less aggressive, but they can be complicated by bacterial endophthalmitis. Additionally, injected drugs such as corticosteroids or antimitotics might facilitate the occurrence of infections. Therefore, even if easy to perform, these new procedures must be performed in strict aseptic conditions, as demonstrated in the studies with antiangiogenic factors, where the incidence of endophthalmitis was divided by 4 when the rules of surgical asepsis were respected. In cases of intravitreal injection of triamcinolone, the main differential diagnosis is pseudoendophthalmitis, an aseptic inflammatory reaction with hyalitis and hypopyon, which occurs within 3 days and spontaneously resolves. Endophthalmitis after 25-G surgery might be related to the absence of suture and to the vitreous incarcerated in the sclerotomy.
Cochereau
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Service d'Ophtalmologie, CHU, Angers. iscohereau@chu-angers.fr
D000208:Acute Disease; D001207:Asepsis / Q000379:methods; D001424:Bacterial Infections / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D003937:Diagnosis, Differential; D009877:Endophthalmitis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D007267:Injections; D013508:Ophthalmologic Surgical Procedures; D019736:Prostheses and Implants; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D014821:Vitrectomy; D014822:Vitreous Body / Q000187:drug effects