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. 2016 Sep 20:16:496.
doi: 10.1186/s12879-016-1830-6.

Vancomycin in infusion during vitrectomy in surgical treatment of acute postoperative and posttraumatic endophthalmitis

Robert Rejdak  1   2 , Tomasz Choragiewicz  1   3 , Agnieszka Kalinowska  1 , Michael J Koss  4 , Piotr Ksiazek  5 , Joanna Moneta-Wielgos  1 , Ryszard Maciejewski  6 , Anselm G Jünemann  7 , Katarzyna Nowomiejska  8
Affiliations

Vancomycin in infusion during vitrectomy in surgical treatment of acute postoperative and posttraumatic endophthalmitis

Robert Rejdak et al. BMC Infect Dis. .

Abstract

Background: Endophthalmitis is potentially devastating intraocular inflammation following eye trauma or surgery. We describe the visual outcomes and causative pathogens in acute bacterial postoperative and posttraumatic endophthalmitis treated with immediate pars plana vitrectomy (PPV) with Vancomycin dissolved in the infusion fluid.

Methods: Clinical records of consecutive 30 patients with postoperative endophthalmitis and 15 patients with posttraumatic endophthalmitis were evaluated. Vancomycin was administered constantly in the infusion fluid at the time of complete PPV. Cultures were prepared from anterior chamber paracentesis. The mean follow-up period was 13 months.

Results: The visual acuities were improved in 38 cases (84 %) and remained stable in seven cases (16 %). Median post-PPV visual acuity was 1.0 logMAR in a group with postoperative endophthalmitis and 1.3 logMAR in a group with posttraumatic endophthalmitis (p < 0.05). Twenty cases (44 %) were culture-positive (Staphylococcus, Streptococcus, Enterococcus and Bacillus spp).

Conclusions: Early PPV with Vanomycin in infusion leads to vision improvement in patients with both posttraumatic and postoperative endophthalmitis. In our series of 45 cases culture was positive only in half of the cases.

Keywords: Endophthalmitis; Ocular trauma; Vitrectomy.

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Figures

Fig. 1
Fig. 1
Aspiration of the hypopyon for microbiological culture
Fig. 2
Fig. 2
Securing anterior chamber maintainer
Fig. 3
Fig. 3
Posterior vitreous detachment during vitrectomy
Fig. 4
Fig. 4
Shaving peripheral vitreous during vitrectomy
See this image and copyright information in PMC

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