Characteristics and Risks of Endophthalmitis after 25-gauge Vitrectomy Surgery over a 14-year Period

Area of Science:

• Ophthalmology
• Surgical Innovation
• Infectious Disease

Background:

• Microincision vitrectomy surgery (MIVS) is a common surgical technique.
• Endophthalmitis is a serious intraocular inflammation that can lead to vision loss.
• Understanding the risks associated with MIVS is crucial for patient safety.

Purpose of the Study:

• To analyze the incidence, characteristics, and risk factors of endophthalmitis following 25-gauge MIVS.
• To identify specific surgical procedures and intraoperative choices associated with increased endophthalmitis risk.

Main Methods:

• Retrospective analysis of post-MIVS endophthalmitis cases from a private retina practice and an ambulatory surgery center (ASC) between January 2010 and April 2024.
• Data collected included patient demographics, surgical details, vitreous substitutes, and visual acuity outcomes.
• Statistical analysis, including chi-square testing, was used to determine the association between vitreous substitutes, procedure type, and endophthalmitis incidence.

Main Results:

• The overall incidence of endophthalmitis post-25-gauge MIVS was 0.11% (27 cases out of 24,987).
• Pars Plana Vitrectomy (PPV) for macular pucker showed a higher incidence (0.23%) compared to retinal detachment (0.03%) or macular hole (0.0%).
• A significant association was found between the type of vitreous substitute used and endophthalmitis incidence, with balanced salt solution (BSS) being most common in cases (85.2%).

Conclusions:

• The incidence of endophthalmitis after 25-gauge MIVS is low but significant.
• Both the surgical procedure and the choice of vitreous substitute are identified as significant risk factors for endophthalmitis.
• Further research is warranted to explore contributing factors and mitigate the risk of vision-threatening endophthalmitis post-MIVS.