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Effectiveness of immediate vitrectomy and intravitreal antibiotics for post-injection endophthalmitis

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A Correction to this article was published on 18 October 2021

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Abstract

Purpose

To show that an immediate vitrectomy with an intravitreal injection of antibiotics can be an effective approach for the treatment of acute endophthalmitis following intravitreal injections.

Methods

We reviewed all cases of clinical endophthalmitis caused by an intravitreal injection that were treated in our department between March 2012 and November 2019. Only patients that underwent a vitrectomy within 6 h after presentation to the clinic and with a documented visual acuity shortly before the causative event were included. Baseline best-corrected visual acuity (BCVA) before the causative event was compared to BCVA measured within a follow-up period of 8 months (up to 14 months).

Results

In total, 30 eyes of 30 patients were included. The BCVA before the intraocular infection was a mean value of 0.55 logMAR, and the BCVA on the day of the endophthalmitis decreased significantly to 1.66 logMAR. Within 2 months following the pars plana vitrectomy (PPV), the mean BCVA improved to 0.83 logMAR. Eight months following PPV (mean value, 8.20 months; SD, 3.59 months), the mean BCVA was 0.63 logMAR. In the last follow-up interval most of the eyes recovered, and the BCVA did not differ significantly from baseline. Two eyes underwent further pars plana surgery during the follow-up period. No enucleation was required.

Conclusion

In this study, we have shown that an immediate vitrectomy with subsequent intravitreal injection of antibiotics is an effective option for treating post-injection endophthalmitis and frequently results in recovery of vision; thus, it should be performed as early as possible, where available.

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Authors and Affiliations

  1. Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280, Sulzbach, Germany

    Kai Januschowski, Karl Thomas Boden, Peter Szurman, Núria Pérez Guerra, Annekatrin Rickmann & Lukas Bisorca-Gassendorf

  2. Centre for Ophthalmology, University Eye Hospital Tuebingen, Schleichstraße 12, 72076, Tuebingen, Germany

    Kai Januschowski

  3. Department of Ophthalmology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Peter Stalmans

  4. Industrial and Organizational Psychology, Saarland University, Campus A1.3, 66123, Saarbruecken, Germany

    Rudolf Siegel

  5. Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Straße, Building 43, 66421, Homburg, Germany

    Sören Leif Becker

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Correspondence to Lukas Bisorca-Gassendorf.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the Saarland Medical Association (approval number 243/14) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Januschowski, K., Boden, K., Szurman, P. et al. Effectiveness of immediate vitrectomy and intravitreal antibiotics for post-injection endophthalmitis. Graefes Arch Clin Exp Ophthalmol 259, 1609–1615 (2021). https://doi.org/10.1007/s00417-021-05071-w

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