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LONG AXIAL LENGTH IS A RISK FACTOR FOR INFECTIOUS ENDOPHTHALMITIS IN MICROINCISIONAL VITRECTOMY AND MEMBRANE PEELING
Sang Cheol Yang1,2, Dong Seon Kim1,2, Tae Yeon Kim1,2
1Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea; and.
Purpose:
To investigate risk factors of infectious endophthalmitis (IE) in microincision vitrectomy surgery and membrane peeling.
Methods:
The authors retrospectively reviewed the medical records of patients who underwent microincision vitrectomy surgery and membrane peeling for idiopathic and secondary epiretinal membranes. IE incidence and its causative microorganisms were collected. Risk factors for IE development- including age, sex, simultaneous cataract surgery, axial length, refractive error, intraocular pressure, myopic tractional maculopathy (MTM), and diabetes mellitus-were assessed. Main outcome measures were association between IE development and clinical factors.
Results:
Of 3,496 eyes, IE occurred in 16 eyes (0.45%). The causative microorganisms were detected in 12 eyes (75%) showing Staphylococcus epidermidis (n = 9), Staphylococcus aureus (n = 1), Staphylococcus capitis (n = 1), and Enterococcus faecalis (n = 1). More IE developed in female (0.74% vs. 0.12%, P = 0.01), eyes with MTM (5.0% vs. 0.35%, P = 0.001), and high myopia (1.7% vs. 0.34%, P = 0.001). Mean axial length (25.2 ± 3.0 vs. 24.0 ± 1.8 mm), mean age (67.4 ± 8.0 vs. 62.4 ± 12.2 years), simultaneous cataract surgery (0.54% vs. 0.27%), and presence of diabetes mellitus (18.7% vs. 20.9%) were not different between eyes with and without IE. High myopia and MTM were significantly associated with IE (logistic regression; P = 0.009, P = 0.046, respectively). Eyes with MTM (n = 80) and high myopia (n = 294) exhibited significantly lower intraocular pressure on Day 1 (11.2 ± 4.6 mmHg and 12.0 ± 5.1 mmHg, respectively), compared with age-matched controls (13.9 ± 4.3 mmHg and 13.6 ± 4.4 mmHg; P = 0.001 and P = 0.01, respectively).
Conclusion:
In microincision vitrectomy surgery and membrane peeling, eyes with high myopia and MTM, which were likely to have lower intraocular pressure in the early postoperative period, were more susceptible to postoperative IE.
Insights
Infectious endophthalmitis (IE) risk factors in micro-incision vitrectomy surgery with membrane peeling (MIVS-MP) were studied. High myopia and myopic tractional maculopathy (MTM) increase IE susceptibility, potentially due to lower early postoperative intraocular pressure (IOP).
Area of Science:
- Ophthalmology
- Retinal Surgery
- Infectious Diseases
Background:
- Infectious endophthalmitis (IE) is a serious complication following intraocular surgery.
- Micro-incision vitrectomy surgery with membrane peeling (MIVS-MP) is a common procedure for epiretinal membranes (ERM).
- Identifying risk factors for IE after MIVS-MP is crucial for prevention and management.
Purpose of the Study:
- To investigate the incidence and risk factors associated with infectious endophthalmitis (IE) after micro-incision vitrectomy surgery and membrane peeling (MIVS-MP).
Main Methods:
- A retrospective review of medical records of patients undergoing MIVS-MP for epiretinal membranes (ERM).
- Analysis of IE incidence, causative microorganisms, and potential risk factors including age, gender, simultaneous cataract surgery, axial length, refractive error, intraocular pressure (IOP), myopic tractional maculopathy (MTM), and diabetes mellitus (DM).
Main Results:
- The incidence of IE was 0.45% (16 out of 3,496 eyes).
- Common causative organisms included Staphylococcus epidermidis.
- Increased IE risk was observed in females, eyes with MTM (5.0%), and high myopia (1.7%). Eyes with MTM and high myopia showed significantly lower early postoperative IOP.
- No significant difference in IE rates was found for age, axial length, simultaneous cataract surgery, or diabetes mellitus.
Conclusions:
- High myopia and myopic tractional maculopathy (MTM) are significant risk factors for postoperative infectious endophthalmitis (IE) following micro-incision vitrectomy surgery and membrane peeling (MIVS-MP).
- Lower early postoperative intraocular pressure (IOP) in eyes with high myopia and MTM may contribute to increased susceptibility to IE.
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