Pars plana vitrectomy and silicone oil tamponade for acute endophthalmitis treatment.
OBJECTIVE
To evaluate the outcomes of pars plana vitrectomy and silicone oil injection for the treatment of infectious endophthalmitis.


METHODS
35 cases of endophthalmitis secondary to phacoemulsification (20 patients), trabeculectomy (8 patients), perforating trauma (2 patients), trauma (2 patients), corneal transplantation (1 patient), vitrectomy (1 patient) and corneal ulceration (1 patient) were retrospectively studied. Patients were separated into two groups: Group 1 (n=24): intravitreal antibiotic injection, associated with topical and oral antibiotics; Group 2 (n=11): vitrectomy with intravitreal antibiotic injection and silicone oil injection. The follow-up ranged from 1 to 48 months (mean of 16 months).


RESULTS
From 24 patients in group 1, 11 patients (45.83%), had infection controlled with intravitreal antibiotic injection only; 13 patients (54.15%) regressed to uncontrolled endophthalmitis, in which two patients (8.33%) were submitted to evisceration and one patient (4.16%) had corneal melting. The remaining 10 patients (41.66%) with uncontrolled endophthalmitis were submitted to pars plana vitrectomy and silicone oil injection. Six patients (25%) from Group I had retinal detachment during the first month of follow-up and also required pars plana vitrectomy and silicone oil injection. In Group 2 patients (n=11), all of them had controlled infection at the first procedure. In one case (9.09%), a severe proliferative vitreoretinopathy induced loss of vision.


CONCLUSIONS
These results suggest that silicone oil tamponade might be beneficial in the treatment strategy of infectious endophthalmitis.
Centro de Pesquisa Rubens Siqueira - de São José do Rio Preto (SP) - Brasil. rubenssiqueira@terra.com.br
Rubens Camargo
RC
Siqueira
Aline Degasperi Cote
AD
Gil
Fabio
F
Canamary
Mirian
M
Minari
Rodrigo
R
Jorge
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012827:Silicone Oils / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D012827:Silicone Oils