Evaluating the efficacy of pars plana vitrectomy in the management of endophthalmitis after following the endophthalmitis vitrectomy study: A systematic review and meta-analysis

被引:0
作者
Angelia, Maria [1 ]
Amelia, Yufilia Suci [2 ]
Alberta, Ivana Beatrice [3 ]
Tanto, Stefany [4 ]
Pratama, Kevin Gracia [5 ]
机构
[1] Mitra Keluarga Kalideres Hosp, Dept Emergency, Jakarta, Indonesia
[2] Marianum Catholic Hosp, Dept Emergency, Halilulik, East Nusa Tengg, Indonesia
[3] Primasatya Husada Citra Hosp, Dept Ophthalmol, Surabaya, Jawa Timur, Indonesia
[4] Univ Pelita Harapan, Dept Emergency, Jakarta, Indonesia
[5] Fatima Gen Hosp, Dept Emergency, West Kalimantan, Indonesia
来源
TZU CHI MEDICAL JOURNAL | 2024年 / 36卷 / 03期
关键词
Endophthalmitis; Pars plana vitrectomy; Postoperative endophthalmitis; INTRAVITREAL INJECTION; CAUSATIVE ORGANISMS;
D O I
10.4103/tcmj.tcmj_14_24
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Endophthalmitis is a devastating eye complication that requires prompt and effective treatment. A pivotal study in the field of endophthalmitis treatment is the endophthalmitis vitrectomy study (EVS), conducted over a decade ago. The primary objective of this study was to assess the effectiveness of pars plana vitrectomy (PPV) as a treatment option for endophthalmitis following the EVS study. We conducted a comprehensive search across three databases: PubMed, EBSCO host, and ProQuest. Reference lists of published articles were searched. Our study encompassed research conducted between January 2013 and January 2023 to ensure the most up-to-date findings. The best-corrected visual acuity (BCVA) in logMar, causative agents, and predicting factors for visual outcome were evaluated. Nine studies involving 351 eyes were included in the study; however, only eight were included in the meta-analysis. We observed a significant BCVA improvement compared to baseline at 1 month, >1-3 months, >3-6 months, and >= 12-month follow-up, with mean differences of 1.06 (P < 0.001), 1.25 (P < 0.001), 1.41 (P < 0.001), and 1.01 (P < 0.001), respectively. A causative organism was cultured in 61.4% of cases, and the majority of them were Coagulase-negative Streptococcus, Staphylococcus aureus, and Streptococcus sp. Factor associated with better visual acuity includes a younger age, lower intraocular pressure, and culture-negative endophthalmitis. Meanwhile, culture-positive endophthalmitis particularly Streptococcus sp., lower baseline vision, and presence of retinal detachment at initial presentation were identified as a prognostic for poorer visual outcome. PPV demonstrated a significant visual gain in patients with endophthalmitis in the 1(st), 3(rd), and 6(th) months. However, caution is warranted in drawing a definitive conclusion.
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页码:284 / +
页数:9
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