Diagnostic pars plana vitrectomy report of a 21-year retrospective study

G. N. Palexas, W. R. Green, M. F. Goldberg, Y. Ding, M. B. Landers, V. Lakhanpal, J. J. Augsburger, R. Forster, R. Ritch, T. P. Kearns

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45 Scopus citations

Abstract

Purpose: To review the experience of' diagnostic pars plana vitrectomies (PPV). Methods: The authors reviewed 405 consecutive diagnostic PPVs performed between November 1973 and October 1994. Results: Diagnostic vitrectomy was performed in 215 (53%) of 405 eyes for suspected endophthalmitis. Of those 215 cases, acute inflammation was confirmed in 62 (28.8%), 60 (27,9%) had microbial organisms present and 36 (16.7%) were culture-positive. Microbial organisms were observed microscopically in 31 (20%) of 156 patients suspected of postoperative endophthalmitis. Of those 31 cases, 23 (74%) were gram-positive, eleven (37%) of 30 eyes had organisms associated with glaucoma filtering procedures and 20 (16%) of 126 eyes had organisms with non-filtering procedures. The pooled percentage of eyes that developed postoperative endophthalmitis as a complication during the period July 1990 thru June 1994 is 5 (0.046%) out of a heterogeneous group of 10,898 cases operated on at the Wilner Eye Institute for cataract, glaucoma, corneal transplant, pars plana vitrectomy and retinal detachment. Bacteria were identified microscopically in 6 (18%) of 34 post-traumatic cases. Microbial organisms were identified in 23 (92%) of 25 cases with an endogenous infection. Patients with endogenous infections had the most fungal infectious, and the majority were in males. Neoplasms were diagnosed in 58 (14%) of the 405 cases. The most common neoplasm was ocular lymphoma 42 (72%), 69% of which were in females. Only 42 (48.3%) of 87 patients clinically suspected of having ocular lymphoma, actually had ocular lymphoma. Those negative for lymphoma were significantly older (67.4 ± 10 years) compared to those with lymphoma (60.4 ± 14 years) (P = 0.01).

Original languageEnglish (US)
Pages (from-to)281-314
Number of pages34
JournalTransactions of the American Ophthalmological Society
Volume93
StatePublished - 1995

ASJC Scopus subject areas

  • Ophthalmology

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