Acute-onset endophthalmitis following pars plana vitrectomy for symptomatic vitreous opacities: a case series.
Acute-onset endophthalmitis occurred in 0.5% of patients after floaterectomy surgery.
Acute-onset endophthalmitis following pars plana vitrectomy for symptomatic vitreous opacities: a case series.
Pars plana vitrectomy (pars plana vitrectomy) for symptomatic vitreous opacities, commonly referred to as floaterectomy, is an increasingly performed elective procedure that can meaningfully improve quality of life.
The purpose of this study is to report the largest series of acute-onset bacterial endophthalmitis following floaterectomy, characterizing clinical presentation, causative organisms, antibiotic susceptibilities, histopathology, and visual outcomes.
Were included if they developed acute-onset endophthalmitis (within one month of pars plana vitrectomy).
Mean presenting BCVA was 2.1 logMAR (~ 20/2500).
Four of 5 vitreous cultures (80%) were positive: 2 gram-positive (Staphylococcus caprae, Staphylococcus lugdunensis) and 2 gram-negative (Pseudomonas aeruginosa, Serratia marcescens).
Visual outcomes were polarized: 3 of 5 eyes (60%) achieved BCVA ≥ 20/80, while 2 of 5 (40%) progressed to no light perception and underwent enucleation, both involving gram-negative organisms.
Histopathology in one enucleated eye demonstrated extensive intraocular necrosis and suppurative inflammation.
Acute-onset endophthalmitis following floaterectomy is rare, occurring at a rate statistically similar to pars plana vitrectomy for other indications.
However, given that floaterectomy is elective surgery for a largely benign, non-vision-threatening condition, the harm-to-benefit ratio is inherently less favorable than pars plana vitrectomy performed for sight-threatening pathology.
Gram-negative infections were associated with catastrophic and irreversible vision loss, including enucleation.