Faculty of Medicine, University of Toronto, Toronto, Canada.
Department of Ophthalmology, University of Manitoba, Winnipeg, Manitoba, Canada.
Retina. 2024 Sep 1;44(9):1608-1618. doi: 10.1097/IAE.0000000000004143.
To compare visual outcomes of endophthalmitis following intravitreal injections (IVIs) and cataract extraction by causative organism.
Searches in Cochrane Central Register of Controlled Trials, MEDLINE, and Embase identified articles reporting visual outcomes by causative organisms in post-IVI and cataract extraction endophthalmitis cases from January 2010 to February 2022. A random-effects meta-analysis compared visual improvement among endophthalmitis cases caused by causative organisms.
Eighty-five out of 3,317 retrieved studies were included. The highest degree of visual acuity improvement in both post-IVI and postcataract extraction endophthalmitis was seen in cases caused by coagulase-negative staphylococci, followed by gram-negative organisms and other gram-positive organisms such as streptococci and enterococci. Culture-negative cases showed more visual acuity improvement than culture-positive cases in post-IVI endophthalmitis. These results remained consistent when accounting for endophthalmitis treatment, IVI type, condition requiring IVI treatment, follow-up period, and initial preprocedural visual acuity.
Coagulase-negative staphylococci and gram-negative organisms show the most visual acuity improvement in both post-IVI and postcataract extraction endophthalmitis. Other gram-positive organisms such as streptococci and enterococci are associated with less visual improvement. This updated systematic review and meta-analysis revealed that the results of the Endophthalmitis Vitrectomy Study are consistent decades later despite advancements in surgical practices and the evolution of microorganisms over time.
比较玻璃体腔内注射（IVI）和白内障摘除术后眼内炎的病因引起的视觉结果。
在 Cochrane 对照试验中心注册库、MEDLINE 和 Embase 中进行检索，检索 2010 年 1 月至 2022 年 2 月期间报告 IVI 后和白内障摘除术后眼内炎病例中病因引起的视觉结果的文章。采用随机效应荟萃分析比较了由病原体引起的眼内炎病例的视觉改善情况。
在 3317 篇检索文章中，有 85 篇被纳入。在 IVI 后和白内障摘除术后眼内炎中，凝固酶阴性葡萄球菌引起的病例视力提高程度最高，其次是革兰氏阴性菌，其他革兰氏阳性菌如链球菌和肠球菌。在 IVI 后眼内炎中，培养阴性病例比培养阳性病例的视力改善更多。在考虑眼内炎治疗、IVI 类型、需要 IVI 治疗的情况、随访时间和初始术前视力后，这些结果仍然一致。
凝固酶阴性葡萄球菌和革兰氏阴性菌在 IVI 后和白内障摘除术后眼内炎中显示出最高的视力改善。其他革兰氏阳性菌如链球菌和肠球菌与视力改善较少相关。本更新的系统评价和荟萃分析显示，尽管手术实践和微生物随时间的演变取得了进展，但几十年后，眼内炎玻璃体切除术研究的结果仍然一致。
