title: 23-gauge transconjunctival sutureless vitrectomy in treatment of post-operative endophthalmitis.
abstract: OBJECTIVE
  To report the safety and efficacy of 23-gauge (23-G) transconjunctival vitrectomy (TSV) in the surgical management of postoperative endophthalmitis.
  
  
  METHODS
  Ten consecutive patients underwent a 23-G TSV in 2008-2010 after cataract surgery (n = 5) or filtrating surgery (n = 5), and were prospectively studied with a minimum follow-up of 6 months. TSV was performed within a median delay of 1 day after the diagnosis, after one or two injections of intravitreal antibiotics (vancomycin, ceftazidime). Conventional cultures (brain heart infusion media) and/or panbacterial PCR were performed on aqueous humor and/or vitreous samples.
  
  
  RESULTS
  Initial visual acuity was less than or equal to hand motion in all cases, and clinical findings included hypopyon (80%), pupillary fibrin membrane (80%), and dense vitreitis (4+, 100%). The bacteria identified were Gram-positive cocci in 60% of the cases (coagulase-negative staphylococci, 20%; streptococcus, 40%) and Gram-negative bacilli in 10% (moraxella lacunata). All patients had central and peripheral vitrectomy (mean duration, 58.6 ± 16 min). No intraoperative complications were noted. Two patients developed retinal detachment postoperatively and were reoperated. The final visual vision was 20/400 for two patients and 20/50 or better for the other patients.
  
  
  CONCLUSIONS
  23-G TSV allows the surgeon to meet the same objectives as the 20-G technique for the treatment of endophthalmitis.
authors.affiliation: Department of Ophthalmology, CHU de Grenoble, University Hospital, University Joseph Fourier, 38043, Grenoble Cedex 09, France.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Almanjoumi
authors.forename: Aurélie
authors.initials: A
authors.lastname: Combey
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Romanet
authors.forename: Christophe
authors.initials: C
authors.lastname: Chiquet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001082:Aqueous Humor / Q000382:microbiology; D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification; D002387:Cataract Extraction; D003228:Conjunctiva / Q000601:surgery; D004269:DNA, Bacterial / Q000032:analysis; D009877:Endophthalmitis / Q000382:microbiology / Q000601:surgery*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications; D011446:Prospective Studies; D013536:Suture Techniques; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial