Silpa-Archa Sukhum, Kumsiang Kwanchanoke, Preble Janine M
Faculty of Medicine, Department of Ophthalmology, College of Medicine, Rajavithi Hospital, Rangsit University, 2 Phayathai Road, Ratchathewi District, Bangkok, 10400, Thailand.
Department of Ophthalmology, Kresge Eye Institute, School of Medicine, Wayne State University, 4717 St. Antoine, Detroit, MI, 48201, USA.
Int J Retina Vitreous. 2021 Jan 6;7(1):2. doi: 10.1186/s40942-020-00274-5.
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.
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.
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.
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.
描述使用回收一次性器械的玻璃体切割术（PPV）后眼内炎的发生率、临床特征及治疗结果。并讨论推荐的消毒流程及安全措施。
对PPV术后发生眼内炎的患者病历进行回顾性分析，并以描述性方式报告。排除因既往存在眼内炎或开放性眼球损伤而接受PPV的病例。数据收集包括患者人口统计学资料、手术细节、眼部检查结果、微生物学特征、治疗方式及视力预后。
在过去13年中，共纳入12989例玻璃体切割术。总共有13例患者的13只眼（0.10%）在玻璃体切割术后发生眼内炎。其中，20G玻璃体切割术3例（0.11%），23G玻璃体切割术8例（0.09%），25G玻璃体切割术2例（0.18%）。20G与微切口玻璃体切割术（MIVS）组之间（P = 0.64）以及23G与25G手术方式之间（P = 0.34）无统计学显著差异。5例（45%）培养出致病病原体：3例革兰氏阳性菌、1例革兰氏阴性菌及1例真菌。
接受23G PPV患者的眼内炎发生率与接受25G PPV患者相当。通过我们标准化的器械消毒方案，使用回收一次性器械进行PPV患者的眼内炎发生率在先前发表的结果范围内，此前的结果中玻璃体切割工具使用一次后即丢弃。
