J Korean Ophthalmol Soc.
2023 Feb;64(2):132-141. 10.3341/jkos.2023.64.2.132.
Incidence and Clinical Course of Acute Endophthalmitis after Idiopathic Epiretinal Membrane Surgery with Microincision Vitrectomy
- Affiliations
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- 1Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea
- 2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- 3Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea
- 4Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
- 5Choi Eye Clinic, Gimhae, Korea
- 6Lee Eye Clinic, Busan, Korea
- KMID: 2539917
- DOI: http://doi.org/10.3341/jkos.2023.64.2.132
Abstract
- Purpose
To investigate the incidence and clinical course of acute endophthalmitis after idiopathic epiretinal membrane (iERM) surgery employing microincision vitrectomy (MIVS).
Methods
We retrospectively reviewed the medical records of eyes with acute endophthalmitis developing after iERM surgery via 23- or 25-gauge MIVS from 2011 to 2021. The incidence, culture-positive rate (and responsible bacteria), final visual acuity (VA), and factors affecting poor visual outcomes were assessed.
Results
Acute endophthalmitis developed in 20 of the 12,921 eyes (0.15%) after MIVS. Of these, 14 of 3,180 eyes treated via iERM (0.44%, one per 227 procedures) developed endophthalmitis; the incidence ratio (iERM versus non-iERM) was 7.1 (p < 0.001, 95% confidence interval [CI] = 2.6-22.7). At least one sclerotomy remained unsutured in all eyes after iERM surgery. Thirteen eyes (92.9%) were given intravitreal antibiotic injections after emergency vitrectomy, and one eye was treated with intravitreal antibiotic injection alone. Staphylococcus epidermidis was cultured from four eyes (28.6%); three strains were methicillin-resistant. All final VAs were not better than the initial VAs; the average VA decreased from 20/42 to 20/259 (p < 0.001). Six eyes (42.9%) attained legal blindness status (final VA < 20/200); Macular invasion was a unique risk factor for such blindness (p = 0.020, odds ratio = 35.0, 95% CI = 1.7-703.0).
Conclusions
Acute endophthalmitis developing after iERM surgery with MIVS was more common than such endophthalmitis after other retinal surgery. Approximately 40% of the former patients became legally blind, and the risk was higher in eyes with macular involvement of endophthalmitis.
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