Visual outcome of Pars Plana Vitrectomy following Endophthalmitis – A Vitreo-retinal Surgeon's Experience

Abstract

Purpose: To determine the visual outcome of pars plana vitrectomy following endophthalmitis.

Methods: A retrospective hospital-based study of 20 eyes of consecutive patients who had pars plana vitrectomy by a particular surgeon  following endophthalmitis in the Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh from August – December 2017. Using the Snellen's visual acuity chart, post-operative distant visual acuity improvement was graded 0– 9, with 0 meaning no improvement in visual acuity,  and 9 meaning nine lines of improvement in visual acuity from presenting best corrected visual acuity.

Results: Pre-operative corrected distant visual acuity (CDVA) ranged from perception of light to 6/36. Seventy percent of the patients had  postoperative visual improvement of varying degrees. The mean pre-operative and post-operative CDVA were 2.20 logMAR and 1.40 logMAR  respectively. All the patients tractional retinal detachment and corneal laceration with rhegmatogeneous retinal detachment as co-morbidities did not have visual improvement, and this was statistically significant (p-value = 0.007). There was an association (although not strong) between age range and postoperative visual improvement (p-value = 0.639).

Conclusion: Pars plana vitrectomy helps to prevent or minimize ophthalmic complications from endophthalmitis, thus making it a necessary line of treatment endophthalmitis. Pars plana vitrectomy is therefore a safe and desirable definitive treatment for endophthalmitis, and it confers a good chance of visual improvement.