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Pars plana vitrectomy results of exogenous endophthalmitis in children
Mehmet Cakir1, Osman Cekiç, Gökhan Pekel
1Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. drmcakir@hotmail.com
Insights
Early pars plana vitrectomy with intravitreal antibiotics significantly improved outcomes for pediatric exogenous endophthalmitis. This treatment enhanced both the anatomic and functional success in affected eyes.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Infectious Diseases
Background:
- Exogenous endophthalmitis in children poses a significant threat to vision.
- Prompt diagnosis and intervention are crucial for managing this severe intraocular infection.
Purpose of the Study:
- To determine the causes, microbial cultures, surgical outcomes, complications, and visual results of exogenous endophthalmitis in pediatric patients.
- To evaluate the effectiveness of pars plana vitrectomy and intravitreal antibiotics in treating pediatric exogenous endophthalmitis.
Main Methods:
- A retrospective review of 7 pediatric patients treated for exogenous endophthalmitis between February 2006 and June 2008.
- All patients underwent combined pars plana vitrectomy and intravitreal vancomycin plus ceftazidime.
- Cultures of anterior chamber fluid and vitreous were obtained.
Main Results:
- The primary causes were penetrating eye injuries (4 eyes) and intraocular surgery (3 eyes).
- Visual acuity improved in 5 of 7 eyes post-treatment.
- Positive cultures identified alpha hemolytic Streptococcus and coagulase-negative Staphylococcus.
Conclusions:
- Early pars plana vitrectomy combined with intravitreal vancomycin and ceftazidime injection led to improved anatomic and functional success.
- This treatment approach is effective in managing pediatric exogenous endophthalmitis.
Purpose:
To identify the etiology, culture results, pars plana vitrectomy results, complications, and visual outcome of exogenous endophthalmitis in children.
Methods:
Seven eyes of 7 consecutive pediatric patients who were treated and followed up for exogenous endophthalmitis between February 2006 and June 2008 were included in this study. The etiology of endophthalmos was penetrating eye injuries in 4 eyes and intraocular surgery in 3 eyes. Combined pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection were performed on all 7 eyes. Anterior chamber fluid and vitreous cultures were taken from all eyes. The patient files were inspected retrospectively.
Results:
Mean follow-up time was 10.3 months (4-16 months). Mean age of the patients was 8.5 years (3-14 years). At baseline, visual acuity values of the patients were light perception (n=2), hand movements (n=4), and counting fingers from 1 meter (n=1). At final examination, visual acuity improved in 5 eyes, stayed the same in 1 eye, and decreased in 1 eye. Positive culture results were obtained in 3 eyes: alpha hemolytic Streptococcus (n=2) and coagulase-negative Staphylococcus (n=1). Complications seen after vitreoretinal surgery were transient ocular hypertension, emulsification of silicone oil, phthisis bulbi, and secondary retinal detachment.
Conclusions:
Early pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection improved anatomic and functional success in pediatric eyes with exogenous endophthalmitis.
