Endoscope-assisted vitrectomy using a 25-gauge system for endophthalmitis: a case series

To present a series of seven cases of postoperative endophthalmitis managed with 25-gauge endoscope-assisted vitrectomy using a 10,000-pixel endoscope and to outline the surgical technique and clinical outcomes.

This study included seven consecutive cases of postoperative endophthalmitis treated with 25-gauge endoscope-assisted vitrectomy at Asahikawa Medical University Hospital between November 2024 and September 2025. Anesthesia was selected based on ocular pain severity: sub-Tenon's for mild pain and retrobulbar for severe pain. Best-corrected visual acuity (BCVA) before surgery and at the final visit was compared using the Wilcoxon signed-rank test.

Seven cases (5 males and 2 females) were included. The mean age was 74.0 ± 9.1 years. Prior surgeries included cataract surgery (PEA + IOL) in three cases, pars plana vitrectomy in one case, and filtration surgery in three cases. Preoperative visual acuity was light perception in one case and hand motion in six cases. Retrobulbar anesthesia was used in five cases and sub-Tenon's anesthesia in two cases. Peripheral vitreous shaving was successfully performed without scleral indentation in all cases. Visual acuity improved in all cases, with a mean final BCVA of logMAR 0.36 ± 0.35 (p = 0.022).

Endoscope-assisted vitrectomy may be a useful surgical option for postoperative endophthalmitis.