Related Experiment Video
Updated: Nov 22, 2025
Intravitreal Injection and Quantitation of Infection Parameters in a Mouse Model of Bacterial Endophthalmitis
Published on: February 6, 2021
Endophthalmitis after pars plana vitrectomy with reused single-use devices: a 13-year retrospective study
Sukhum Silpa-Archa1, Kwanchanoke Kumsiang2, Janine M Preble3
1Faculty of Medicine, Department of Ophthalmology, College of Medicine, Rajavithi Hospital, Rangsit University, 2 Phayathai Road, Ratchathewi District, Bangkok, 10400, Thailand. sukhumsilp@gmail.com.
Background:
To describe the incidence, clinical characteristics, and treatment outcomes of endophthalmitis after pars plana vitrectomy (PPV) with recycled single-use devices. The recommended sterilization process as well as safety measures are discussed.
Methods:
Medical charts of patients who developed endophthalmitis after PPV were retrospectively reviewed and reported in a descriptive manner. Cases undergoing PPV for preexisting endophthalmitis or open globe injury were excluded. Data collection included patient demographics, operative details, ocular findings, microbiological profiles, treatment modalities, and visual outcomes.
Results:
Over the past thirteen years, a total of 12,989 pars plana vitrectomy operations were included. In total, 13 eyes of 13 cases (0.10%) experienced endophthalmitis after vitrectomy. These occurred in 3 cases (0.11%) using 20-gauge vitrectomy compared to 8 cases (0.09%) using 23-gauge vitrectomy and 2 cases (0.18%) using 25-gauge vitrectomy. There were no statistically significant differences between the 20-gauge and microincisional vitrectomy surgery (MIVS) group (P = 0.64), and the 23- and 25-gauge approach (P = 0.34). Causative pathogens were positive by culture in 5 cases (45%): 3 g-positive cases, 1 g-negative case, and 1 fungus case.
Conclusions:
The rate of endophthalmitis in patients who underwent 23-gauge PPV was comparable to those who underwent 25-gauge PPV. With our standardized protocol for instrument sterilization, endophthalmitis rates in those undergoing PPV using recycled single-use instruments were within the range of previously published results in which vitrectomy tools were disposed of after one use.
Insights
Endophthalmitis after pars plana vitrectomy (PPV) using recycled instruments occurred in 0.10% of cases. Rates were comparable across different gauge vitrectomy techniques, suggesting safety with standardized sterilization protocols.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Infectious Disease
Background:
- Endophthalmitis is a serious complication following intraocular surgery.
- Pars plana vitrectomy (PPV) is a common vitreoretinal surgical procedure.
- The use of recycled single-use devices in PPV raises questions about infection risk.
Purpose of the Study:
- To determine the incidence and characteristics of endophthalmitis after PPV using recycled single-use instruments.
- To evaluate the safety and efficacy of a standardized sterilization protocol for these devices.
- To compare endophthalmitis rates across different vitrectomy gauges.
Main Methods:
- Retrospective review of medical charts for patients who developed endophthalmitis post-PPV.
- Exclusion of cases with pre-existing endophthalmitis or open globe injury.
- Data collection on demographics, surgical details, ocular findings, microbiology, treatment, and visual outcomes.
Main Results:
- 13 cases (0.10%) of endophthalmitis occurred in 12,989 PPV operations over 13 years.
- Incidence rates were similar for 20-gauge (0.11%), 23-gauge (0.09%), and 25-gauge (0.18%) vitrectomy.
- No statistically significant differences in endophthalmitis rates were found between 20-gauge and microincisional vitrectomy surgery (MIVS) groups, or between 23- and 25-gauge approaches.
- Cultures were positive in 5 cases (45%), including gram-positive bacteria, gram-negative bacteria, and fungi.
Conclusions:
- The rate of endophthalmitis after 23-gauge PPV is comparable to 25-gauge PPV.
- Standardized sterilization protocols for recycled single-use instruments yield endophthalmitis rates within previously published ranges.
- Recycled single-use instruments can be safely employed in PPV with appropriate sterilization.
