Abstract
We investigated vitreous replacement by longlasting gas in the management of severe Staphylococcus aureus endophthalmitis in 19 rabbits randomized for vitrectomy (9 animals) and for vitrectomy followed by replacement of the vitreous by a 20% perfluoropropane-80% air mixture (10 animals). Both groups received systemic antibiotics and achieved comparable intraocular antibiotic levels. Clinically and histopathologically, gas-filled eyes demonstrated less inflammation than did eyes without gas (P < 0.01). Replacement of vitreous by gas offers an effective adjunct to vitrectomy by eliminating a culture medium, preventing vitreous abscess formation, enabling fundus visualization, and delaying the onset of retinal detachment.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abel R Jr, Boyle GL, Furman M, Leopold IH (1974) Intraocular penetration of cefazolin sodium in rabbits. Am J Ophthalmol 78:779–787
Arret B, Johnson DP, Kirshbaum A (1971) Outline of details for micorbiological assays of antibiotics — second revision. J Pharm Sci 60:1689–1694
Barza M, Kane A, Baum J (1983) Comparison of the effects of continuous and intermittent systemic administration on the penetration of gentamycin into infected rabbit eyes. J Infect Dis 147:144–148
Belmont JB, Michelson JB (1982) Vitrectomy in uveitis associated with ankylosing spondylitis. Am J Ophthalmol 94:300–304
Blumenkranz M, Gardner T, Blankenship G (1986) Fluid-gas exchange and photocoagulation after vitrectomy. Arch Ophthalmol 104:291–296
Csukas S, Paterson CA, Brown K, Bhattacherjee P (1990) Time course of rabbit ocular inflammatory response and mediator release after intravitreal endotoxin. Invest Ophthalmol Vis Sci 31:382–387
De Juan E Jr, McCuen B, Tiedeman J (1985) Intraocular tamponade and surface tension. Surv Ophthalmol 30:47–51
Diamond JG (1981) Intraocular management of endophthalmitis; a systematic approach. Arch Ophthalmol 99:96–99
Graham RO, Peyman GA (1974) Intravitreal injection of dexamethasone. Arch Ophthalmol 92:149–154
Kaplan HJ, Diamond JG, Brown SA (1979) Vitrectomy in experimental uveitis: II. Method in eyes with protein-induced uveitis. Arch Ophthalmol 97:336–339
Martin DF, Ficker LA, Aguilar HA, Gardner SK, Wilson LA, Meredith TA (1990) Vitreous cefazolin levels after intravenous injection; effects of inflammation, repeated antibiotic doses, and surgery. Arch Ophthalmol 108:411–414
McGetrick JJ, Peyman GA (1979) Vitrectomy in experimental endophthalmitis: 11. Bacterial endophthalmitis. Ophthalmol Surg 10:87–92
Mester U, Volker B (1983) Intraocular penetration of systemically administered cephalosporines into the vitrectomized rabbit eye. Fortschr Ophthalmol 80:159–161
O'Day DM, Jones DB, Patrinelly J, Elliott JH (1982) Staphylococcus epidermidis endophthalmitis; visual outcome following noninvasive therapy. Ophthalmology 89:354–360
Ogura Y, Tsukada T, Negi A, Honda Y (1989) Integrity of the blood-ocular barrier after intravitreal gas injection. Retina 9:199–202
Pavan PR, Brinser JH (1987) Exogenous bacterial endophthalmitis treatment without systemic antibiotics. Am J Ophthalmol 104:121–126
Peyman GA, Paque IT, Meisels HI, Bennett TO (1975) Postoperative endophthalmitis; a comparison of methods for treatment and prophylaxis with gentamycin. Ophthalmic Surg 6:45–55
Physicians' Desk Reference, 43rd edn. (1989) Medical Economics Co., Oradell, New Jersey, pp 2037–2039
Rowsey JJ, Newsom DL, Sexton DJ, Harms WK (1982) Endophthalmitis; current approaches. Ophthalmology 89:1055–1066
Stallman JB, Meyers SM (1988) Repeated fluid-gas exchange for hypotony after vitreoretinal surgery for proliferative vitreoretinopathy. Am J Ophthalmol 166:147–153
Stefansson E, McCuen BW II, McPherson SD Jr (1984) Biconcave contact lens for examination and laser treatment of the fundus in normal and gas-filled phakic eyes. Am J Ophthalmol 98:806–807
Stern GA, Engel HM, Driebe WT (1989) The treatment of postoperative endophthalmitis — results of differing approaches to treatment. Ophthalmology 96:62–67
Talley AR, D'Amico DJ, Talamo JH, Casey VNJ, Kenyon KR (1987) The role of vitrectomy in the treatment of postoperative bacterial endophthalmitis; an experimental study. Arch Ophthalmol 105:1699–1702
Thomas MA, O'Grady GE, Swartz SL (1985) Prostaglandin levels in human vitreous. Br J Ophthalmol 69:275–279
Author information
Authors and Affiliations
Additional information
Presented in part at the 1989 meeting of the Ocular Microbiology and Immunology Group, New Orleans, Louisiana, and at the 1990 meeting of the Association for Research in Vision and Ophthalmology, Sarasota, Florida
Offprint requests to: A. Mansour
Rights and permissions
About this article
Cite this article
Mansour, A.M., Ferguson, E., Lucia, H. et al. Vitreous replacement by gas as a therapeutic modality in bacterial endophthalmitis. Graefe's Arch Clin Exp Ophthalmol 229, 468–472 (1991). https://doi.org/10.1007/BF00166312
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00166312