Outcomes of Complete Pars Plana Vitrectomy with Silicone Oil versus Pars Plana Vitrectomy Alone in Cases of Postoperative Endophthalmitis

Abstract

Background: Postoperative endophthalmitis is a severe and sight-threatening complication following ocular surgery. Pars plana  vitrectomy (PPV) is a common intervention, and the use of silicone oil endotamponade may offer additional benefits.

Objective: To  compare outcomes of complete PPV with silicone oil endotamponade versus pars plana vitrectomy alone in cases of postoperative  endophthalmitis.

Patients and Methods: This prospective, randomized, controlled trial included 40 consecutive cases of postoperative endophthalmitis. Patients unresponsive to initial aspiration and intravitreal antibiotics were randomized into two groups: Group 1 (n=20)  underwent PPV alone, and Group 2 (n=20) underwent PPV with silicone oil endotamponade. All patients received systemic and fortified  topical antibiotics, with follow-up assessments at 1, 2, 4, and 12 weeks postoperatively. Silicone oil was removed from Group 2 eight  weeks post-surgery. Primary outcome measures included visual acuity, intraoperative retinal breaks, and postoperative complications  such as rhegmatogenous retinal detachment (RRD).

Results: The mean age of patients was 52 years, with 22 females (55%) and 18 males  (45%). There was no significant difference in visual acuity outcomes between the two groups (p > 0.05). However, intraoperative retinal  breaks were significantly more common in Group 1 (45%) compared to Group 2 (0%) (p = 0.001). Additionally, the incidence of RRD was  significantly higher in Group 1 (35%) than in Group 2 (0%) (p = 0.008).

Conclusion: PPV incorporating primary silicone oil endotamponade  yields superior anatomical and functional results in postoperative endophthalmitis cases compared to PPV performed  without silicone oil.