Comparative Outcomes of Primary Vitrectomy Versus Tap and Inject for Endophthalmitis Following Phacoemulsification...

Area of Science:

• Ophthalmology
• Infectious Diseases

Background:

• Endophthalmitis is a serious complication following cataract surgery.
• Prompt and effective treatment is crucial for preserving vision.

Purpose of the Study:

• To compare functional and anatomical outcomes of primary vitrectomy versus tap and injection (T&I) for endophthalmitis after phacoemulsification.
• To evaluate culture positivity rates and the number of procedures required for each treatment approach.

Main Methods:

• Retrospective comparison of patients with endophthalmitis post-phacoemulsification (2007-2016).
• Outcomes assessed included visual acuity, culture results, and number of interventions.
• Two treatment groups: primary vitrectomy with intravitreal antibiotics and vitreous tap with antibiotic injection (T&I).

Main Results:

• Both T&I and primary vitrectomy significantly improved visual acuity.
• Primary vitrectomy showed a significantly greater median improvement in visual acuity.
• Fewer patients in the primary vitrectomy group required additional procedures (26%) compared to the T&I group (68%).
• The T&I group underwent more procedures on average (2.3) than the primary vitrectomy group (1.5).

Conclusions:

• Primary vitrectomy for endophthalmitis resulted in superior visual improvement and required fewer subsequent procedures.
• Primary vitrectomy demonstrated greater efficacy in sterilizing the eye, as viable bacteria were only found in later procedures in the T&I group.