Multicenter survey with a systematic overview of acute-onset endophthalmitis after transconjunctival microincision vitrectomy surgery.
OBJECTIVE
To explore the incidence and visual outcomes of acute-onset endophthalmitis after transconjunctival microincision vitrectomy surgery (MIVS).


METHODS
Retrospective, interventional, multicenter survey with a systematic review.


METHODS
A clinical database search was performed at 27 institutions involving 43 868 consecutive patients who underwent vitrectomy between November 2003 and October 2008 to identify all patients with endophthalmitis after vitrectomy. A systematic review of studies reporting the endophthalmitis rates after MIVS versus 20-gauge vitrectomy was conducted to assess the pooled incidence rates of postvitrectomy endophthalmitis.


RESULTS
The endophthalmitis rates from the multicenter survey were 0.034% (10 cases per 29 030 eyes) after 20-gauge vitrectomy and 0.054% (8 cases per 14 838 eyes) after MIVS, with no significant (P = .603) differences between groups. Although the incidence in 25-gauge cases (6 per 8238 eyes; 0.073%) was greater than in 23-gauge cases (2 per 6600 eyes; 0.030%), the difference was not significant (P = 0.451). Of 8 eyes in which endophthalmitis developed after MIVS, 6 eyes (75%) had a final visual acuity of 0.5 or better, and none lost light perception. By combining the results of 7 studies, including the current multicenter survey, meta-analyses from a total of 77 956 cases at the baseline showed that the pooled endophthalmitis rates after MIVS (0.08%; 95% confidence interval, 0.030% to 0.164%) and after 20-gauge vitrectomy (0.030%; 95% confidence interval, 0.012% to 0.048%) did not differ significantly (P = .207, pooled risk difference; 0.0005 [95% confidence interval, -0.0002 to 0.0012]).


CONCLUSIONS
The incidence of postvitrectomy endophthalmitis was low with no significant differences between MIVS and 20-gauge vitrectomy.
Oshima
Yusuke
Y
Department of Ophthalmology, Osaka University Medical School, Suita, Japan. yusukeoshima@gmail.com
Kadonosono
Kazuaki
K
Yamaji
Hidetaka
H
Inoue
Makoto
M
Yoshida
Munenori
M
Kimura
Hideya
H
Ohji
Masahito
M
Shiraga
Fumio
F
Hamasaki
Toshimitsu
T
D000208:Acute Disease; D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000601:surgery*; D009877:Endophthalmitis / Q000453:epidemiology / Q000209:etiology*; D015818:Eye Infections, Bacterial / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D012164:Retinal Diseases / Q000601:surgery; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*