title: Endophthalmitis After Pars Plana Vitrectomy: Clinical Features, Risk Factors, and Management Outcomes.
abstract: OBJECTIVE
  To report the clinical presentations, risk factors, and outcomes of endophthalmitis after pars plana vitrectomy at 4 tertiary eye care centers of an institute in South India.
  
  
  METHODS
  A retrospective case series.
  
  
  METHODS
  The records of 38,591 patients undergoing vitrectomy were reviewed using the coding assigned by the medical records department. Consecutive cases diagnosed as endophthalmitis after pars plana vitrectomy (PPV) between 1990 and 2014 for various indications were analyzed.
  
  
  RESULTS
  The clinical incidence of postvitrectomy endophthalmitis was 0.052%, and culture-positive incidence of postvitrectomy endophthalmitis was 0.031%. Twelve cases (60%) were culture positive. Mean presenting vision was 2.16 ± 1.51 logMAR (Snellen equivalent 20/2890). Seventeen eyes had received sutureless vitreous surgery (15 cases 23G, 2 cases 25G) and 3 eyes had received 20G suture-assisted vitreous surgery (P < 0.0001). The odds of developing endophthalmitis in sutureless versus sutured vitrectomy were 25.14 [95% confidence interval (CI), 7.37-85.84] (P < 0.0001) and those of developing endophthalmitis in sutureless surgery versus sutured with final tamponade of Ringer lactate (RL) were 19.53 (95% CI, 5.37-71.03) (P < 0.0001). In sutureless surgeries, the odds of developing endophthalmitis in RL tamponaded eyes versus non-RL ones was 4.39 (95% CI, 1.67-11.56) (P = 0.002). Mean interval between vitreous surgery and endophthalmitis was 4 ± 6.89 days; median, 1.5 days. Mean postoperative vision was 1.7 ± 1.36 logMAR (Snellen equivalent 20/1002) (P = 0.31).
  
  
  CONCLUSIONS
  Endophthalmitis after vitrectomy is an acute presentation. Sutureless surgery, especially with aqueous tamponade, has a higher risk. The visual outcome is relatively poor.
authors.affiliation: From the *Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad; †LV Prasad Eye Institute, Visakhapatnam; ‡Cornea and Anterior Segment Services, LV Prasad Eye Institute, Hyderabad; §Retina and Vitreous Service, LV Prasad Eye Institute, Bhubaneswar; ¶Retina and Vitreous, Service, LV Prasad Eye Institute, Vijayawada; and ∥Jhaveri Microbiology Center, Brian Holden Eye Research Center, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: Vivek Pravin
authors.initials: VP
authors.lastname: Dave
authors.forename: Avinash
authors.initials: A
authors.lastname: Pathengay
authors.forename: Sayan
authors.initials: S
authors.lastname: Basu
authors.forename: Namrata
authors.initials: N
authors.lastname: Gupta
authors.forename: Soumyava
authors.initials: S
authors.lastname: Basu
authors.forename: Vishal
authors.initials: V
authors.lastname: Raval
authors.forename: Taraprasad
authors.initials: T
authors.lastname: Das
authors.forename: Savitri
authors.initials: S
authors.lastname: Sharma
authors.forename: Annie
authors.initials: A
authors.lastname: Mathai
authors.forename: Raja
authors.initials: R
authors.lastname: Narayanan
authors.forename: Jay
authors.initials: J
authors.lastname: Chhablani
authors.forename: Pranjali
authors.initials: P
authors.lastname: Sharma
authors.forename: Mudit
authors.initials: M
authors.lastname: Tyagi
authors.forename: Divya
authors.initials: D
authors.lastname: Balakrishnan
authors.forename: Subhadra
authors.initials: S
authors.lastname: Jalali
authors.forename: Padmaja Kumari
authors.initials: PK
authors.lastname: Rani
authors.forename: Rajeev Reddy
authors.initials: RR
authors.lastname: Pappuru
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D009877:Endophthalmitis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013536:Suture Techniques; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects* / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents