title: Occurrence and risk factors for retinal detachment after pars plana vitrectomy in acute postcataract bacterial endophthalmitis.
abstract: OBJECTIVE
  To report the incidence, risk factors and prognosis of retinal detachment (RD) in patients who had vitrectomy for acute bacterial endophthalmitis after cataract surgery.
  
  
  METHODS
  123 patients with acute postcataract endophthalmitis, consecutively treated with pars plana vitrectomy (PPV) were included by the French Institutional Endophthalmitis Study group, in a prospective multicentre cohort study. Risk factors of RD were analysed using logistic regression.
  
  
  RESULTS
  At the 6-month follow-up, the rate of post-PPV RD was 13% (n=16). The risk factors of post-PPV RD were diabetes (OR=4.7 (1.4-15.4), p=0.01) and visualisation of retinal vasculitis on the posterior pole (OR=3.8 (1.1-13.9), p=0.03) at the time of PPV. Postoperative RD occurred in 56% (n=9) of cases in the first month, in 31% (n=5) in the second month and in 6% (n=1) in the third month, with a mean delay of 47±71 days after PPV. The macula was detached in 12 cases (75%) and proliferative vitreoretinopathy grade C was present in seven cases. Final successful reattachment of the retina was obtained in 60% (n=9/15) of cases, with one (7/9) or two surgeries (2/9). Final visual acuity after surgical repair was ≥20/40 in 19% of cases, compared with 43% in patients without RD (p=0.05).
  
  
  CONCLUSIONS
  RD is a major and severe complication of PPV performed in patients with acute postcataract endophthalmitis. Retinal vasculitis is a major risk factor of RD after PPV. Anatomical and functional outcome remain poor.
authors.affiliation: Grenoble Alpes University, Grenoble, France Department of Ophthalmology, University Hospital, Grenoble, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Chiquet
authors.affiliation: Grenoble Alpes University, Grenoble, France Department of Ophthalmology, University Hospital, Grenoble, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Aptel
authors.affiliation: Grenoble Alpes University, Grenoble, France Department of Ophthalmology, University Hospital, Grenoble, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Combey-de Lambert
authors.affiliation: Department of Ophthalmology, University Hospital, Dijon, France.
authors.forename: Alain M
authors.initials: AM
authors.lastname: Bron
authors.affiliation: Department of Ophthalmology, University Hospital, Saint-Etienne, France.
authors.forename: Nelly
authors.initials: N
authors.lastname: Campolmi
authors.affiliation: Grenoble Alpes University, Grenoble, France Department of Ophthalmology, University Hospital, Grenoble, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Palombi
authors.affiliation: Department of Ophthalmology, University Hospital, Saint-Etienne, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Thuret
authors.affiliation: Department of Ophthalmology, Edouard Herriot University Hospital, University of Lyon I, Lyon, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Rouberol
authors.affiliation: Department of Ophthalmology, Edouard Herriot University Hospital, University of Lyon I, Lyon, France.
authors.forename: Pierre-Loïc
authors.initials: PL
authors.lastname: Cornut
authors.affiliation: Department of Ophthalmology, University Hospital, Dijon, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Creuzot-Garcher
mesh_terms: D000208:Acute Disease; D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000150:complications* / Q000175:diagnosis; D015818:Eye Infections, Bacterial / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012163:Retinal Detachment / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000150:complications* / Q000175:diagnosis; D014821:Vitrectomy / Q000009:adverse effects*
keywords: Infection; Inflammation; Microbiology; Retina; Treatment Surgery