Original articleIncidence of Endophthalmitis after 20- and 25-Gauge Vitrectomy
Section snippets
Patients and Methods
Eight-thousand six-hundred one consecutive pars plana vitrectomy cases performed by the Wills Eye Institute Retina Service between January 1, 2004, and August 31, 2006, were reviewed. All surgeries were performed at 1 of 4 surgical locations, which had comparable ancillary support staff and comparable preoperative prepping protocols. All surgeries were performed by 1 of 18 Wills Retina Service physicians.
Preoperative eye preparation in all eyes included eyelid and periorbital scrubbing with
Results
Of the 8601 consecutive cases, 8 (0.09%) had postoperative endophthalmitis. There were 5498 cases of 20-gauge vitrectomy and 3103 cases of 25-gauge vitrectomy. One of 5498 20-gauge vitrectomy cases had endophthalmitis (0.018%), and 7 of 3103 25-gauge vitrectomy cases had endophthalmitis (0.23%; P = 0.004, Fisher exact test, 2 tailed). For the 25-gauge trocar and cannula placement, the vast majority of cases had conjunctival displacement, but no beveling of the surgical wound was performed.
Of
Discussion
Endophthalmitis after intraocular surgery is rare; however, it can result in devastating visual loss. Postoperative endophthalmitis rates vary by surgical procedure. For example, glaucoma procedures tend to have slightly higher rates of endophthalmitis, with a 0.20% rate of endophthalmitis after trabeculectomy.6 Cataract surgery has a low 0.04% incidence of endophthalmitis.6 However, the endophthalmitis rates have not always been this low. As cataract surgery has evolved from intracapsular
Acknowledgment
The authors thank the vitreoretinal surgeons who performed the surgeries involved in this study: Gary Brown, Mitchell Fineman, Allen Ho, Richard Kaiser, J. Arch McNamara, Carl Regillo, James Vander, David Fischer, Sunir Garg, Jay Federman, Carl Park, Arunan Sivalingam, Jonathan Belmont, Robert Kleiner, Mike Samuel, Brian Connolly, and Adam Martidis.
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Manuscript no. 2007-233.