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Ten-year trends in the incidence, clinical profile and outcomes of acute-onset endophthalmitis following combined pars plana vitrectomy and sutureless, glueless and flapless scleral fixation of intraocular lenses

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Abstract

Purpose

To evaluate the frequency and outcomes of acute-onset endophthalmitis following combined pars plana vitrectomy and scleral fixation of intraocular lens.

Methods

We evaluated patients undergoing a sutureless, glueless, flapless technique of scleral fixation of intraocular lenses (SFIOL) implantation for various causes of aphakia and documented the clinico-demographic data, microbiological profile and final outcome after acute endophthalmitis in this cohort of eyes.

Results

The frequency of suspected acute endophthalmitis diagnosed post-surgery was 0.112% (4/3541 eyes), with culture-positive endophthalmitis frequency being 0.028% (1 eye), showing growth of Pseudomonas aeruginosa. Mean age of patients with endophthalmitis was 51.75 ± 9.28 years, and mean interval between surgery and acute endophthalmitis presentation was 10.25 ± 9.6 days. Patients were managed with intravitreal antibiotics with or without core vitrectomy. Visual acuity of patients increased from baseline 1.43 ± 0.32 logMAR (Snellen equivalent = 6/150) to 0.79 ± 0.16 logMAR (Snellen equivalent = 6/36) after an average follow-up of 11 ± 2 weeks.

Conclusion

Endophthalmitis is a rare complication following SFIOL surgery, and all ophthalmic surgeons must be aware of this inadvertent possibility, since SFIOLs are gaining wider acceptability recently. Moreover, these cases of endophthalmitis may show a different pattern of microorganisms than post-cataract surgery endophthalmitis; however, with prompt diagnosis and effective timely management, favorable outcomes can be achieved.

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Data are available with the corresponding author on request.

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Funding

No funds were needed for this study.

Author information

Author notes

  1. Naresh Babu Kannan and Sagnik Sen equal contribution as first author.

Authors and Affiliations

  1. Department of Vitreo-Retina, Aravind Eye Hospital, Madurai, India

    Naresh Babu Kannan, Sagnik Sen, Chitaranjan Mishra, Karthik Kumar, Renu P. Rajan & Kim Ramasamy

  2. Department of Microbiology, Aravind Eye Hospital, Madurai, India

    Prajna Lalitha & Gunasekaran Rameshkumar

Authors
  1. Naresh Babu Kannan
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  2. Sagnik Sen
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Contributions

NBK contributed to concept design and final approval; SS helped with data collection and analysis, drafting manuscript and final approval; CM contributed to data collection and final approval; and KK, RPR and KR helped with final approval.

Corresponding author

Correspondence to Sagnik Sen.

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Conflict of interest

None of the authors declares that they have any conflict of interest.

Consent to participate

Informed consent was obtained from all individual participants included in the study at the time of their treatments performed.

Consent to publication

Informed consent for potential research publication was obtained from all individual participants included in the study at the time of their treatments performed.

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Not Applicable.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards (Aravind Eye Hospital Institutional Research Committee, RET201900207). Informed consent was obtained from all individual participants included in the study.

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Kannan, N.B., Sen, S., Mishra, C. et al. Ten-year trends in the incidence, clinical profile and outcomes of acute-onset endophthalmitis following combined pars plana vitrectomy and sutureless, glueless and flapless scleral fixation of intraocular lenses. Int Ophthalmol 41, 1651–1658 (2021). https://doi.org/10.1007/s10792-021-01715-2

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