Outcome of 23-gauge sutureless transconjunctival vitrectomy for endophthalmitis Dr Colin S.H. Tan.

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Outcome of 23-gauge sutureless transconjunctival vitrectomy for endophthalmitis Dr Colin S.H. Tan

Acknowledgments Dr Hon Kiat WONG Dr Francine YANG Dr Jong Jian LEE The authors have no financial or proprietary interests in the subject of this poster

Introduction Endophthalmitis is a potentially devastating eye infection Postoperative endophthalmitis reported in between 0.04% to 0/12% of cases Vitrectomy may be useful in treatment of endophthalmitis, especially with visual acuity of light perception or worse. No previous report on use of 23-G sutureless vitrectomy to treat endophthalmitis

Objectives To review the feasibility and surgical outcomes of using 23G transconjunctival vitrectomy for the treatment of endophthalmitis

Methods Non-randomized, interventional case series study All patients presenting with postoperative endophthalmitis over a 1-year period from April 2005 to March 2006 Main outcome measures: intraoperative and posteroperative complications (hypotony, wound leak, chemosis)

Results Vitrectomy was performed on 6 patients (4 acute and 2 chronic endophthalmitis) Mean surgical time 58.3 minutes (range 40 – 75) Mean follow-up 13.2 months (range, 9 –17)

Surgical outcomes Thorough clearance of the vitreous base was achieved No severe postoperative pain No wound leak / hypotony Mean IOP on 1 st postoperative day was 17.3 mmHg (SD  3.4, range, 12 – 21 mmHg) Mean IOP change -4.2 mmHg compared to the preoperative IOP (p=0.239)

Visual outcomes ≥ 20/40 in 5 of 6 patients (83.3%) overall ≥ 20/40 in 3 of 4 patients (75%) with acute endophthalmitis Final visual acuity (VA) significantly improved compared to preoperative VA (p=0.026)

Characteristics of patients

Discussion Advantages of transconjunctival vitrectomy: Reduced surgical time Less postoperative discomfort Shorter recovery time Concern about postoperative hypotony due to sutureless sclerostomy Able to clear vitreous base without difficulty using 23-gauge instruments

Conclusion 23-gauge transconjunctival vitrectomy can be performed safely for both acute and chronic endophthalmitis Good final visual acuity No cases of hypotony or severe complications