Comparative outcomes of pars plana vitrectomy in acute postoperative endophthalmitis with 25-gauge and 20-gauge techniques.
OBJECTIVE
To evaluate the safety and outcomes of 25-gauge pars plana vitrectomy (PPV) in the treatment of postoperative endophthalmitis and compare it with 20-gauge PPV.


METHODS
The medical records of all patients diagnosed with acute endophthalmitis following cataract surgery who underwent PPV between December 2000 and December 2007 were reviewed. Main outcome measures included final visual acuity (VA), additional interventions, and both intraoperative and postoperative complications.


RESULTS
Records of 70 eyes of 70 patients with a condition diagnosed as postoperative endophthalmitis were evaluated. Fifty-eight eyes underwent 20-gauge PPV (group 1), and 12 eyes underwent 25-gauge PPV (group 2). Mean follow-up time for group 1 was 9.6 +/- 8.8 months, and for group 2, 7.9 +/- 12.7 months (P = 0.57). Median VA at presentation was hand motion in both groups. The differences between the two groups in frequencies of visual outcome levels of 20/800 and 20/100 were significant in favor of group 2 (20/800, P = 0.006; 20/100, P = 0.01). In group 2, fewer additional interventions were required, and postoperative complications tended to be less frequent.


CONCLUSIONS
Twenty-five-gauge PPV seems to be safe and effective in the management of postoperative endophthalmitis. This sutureless technique may have some advantages over 20-gauge surgery, but controlled studies are needed to confirm the results.
Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. tugrulaltan@gmail.com
Tugrul
T
Altan
Ziya
Z
Kapran
Ilker
I
Eser
Nur
N
Acar
Yaprak Banu
YB
Unver
Serap
S
Yurttaser
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification; D009877:Endophthalmitis / Q000382:microbiology / Q000601:surgery*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011183:Postoperative Complications; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000382:microbiology