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Endophthalmitis after 25-gauge pars plana vitrectomy
Larissa Magosso1, André Maia, Mauricio Maia
1From the Department of Ophthalmology, Paulista School of Medicine, Federal University of São Paulo, IPEPO, São Paulo, Brazil.
Retinal Cases & Brief Reports
|November 13, 2014
Summary
Vitreous incarceration is a risk factor for intraocular infection after 25-gauge vitrectomy. Careful technique, including trypan blue staining, can minimize infection risk in this sutureless procedure.
Area of Science:
- Ophthalmology
- Surgical Innovation
Background:
- Twenty-five-gauge vitrectomy offers sutureless surgery via transconjunctival incisions.
- Despite its minimally invasive nature, the risk of intraocular infection persists.
Purpose of the Study:
- To report a case of endophthalmitis following 25-gauge vitrectomy.
- To discuss potential mechanisms contributing to this complication.
Main Methods:
- A case of infectious endophthalmitis after 25-gauge vitrectomy for proliferative diabetic retinopathy is presented.
- Surgical findings included "mushroom-shaped" tissue and purulent discharge at sclerotomy sites.
Main Results:
- Infectious endophthalmitis developed on postoperative day three.
- Despite reoperation, visual acuity deteriorated to no light perception, necessitating evisceration.
Conclusions:
- Vitreous incarceration is identified as an additional risk factor for intraocular infection post-25-gauge vitrectomy.
- Techniques like conjunctival displacement, beveled incisions, and trypan blue staining of extruded vitreous are crucial for prevention.
- Other contributing factors include immunosuppression, prolonged procedure duration, and multiple instrument entries.
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