OUTCOMES OF RHEGMATOGENOUS RETINAL DETACHMENT REPAIR FOLLOWING INFECTIOUS ENDOPHTHALMITIS. Issue 4 (April 2023)

• Record Type: Journal Article
• Authors: Wu, Frances; Kim, Leo A.
• Is Part Of: Retina. Volume 43:Issue 4(2023)
• Page Start: 600
• Page End: 605
• Publication Date: 2023-04
• Subjects: endogenous -- endophthalmitis -- exogenous -- infection -- proliferative vitreoretinopathy -- retinal detachment; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000003706
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : This retrospective study examined the rate of and risk factors for redetachment following initial successful repair of retinal detachment associated with infectious endophthalmitis. Early vitrectomy yielded high culture positivity with no increase in redetachment rates. Half of eyes redetached. Significant risk factors were organism virulence, hypotony, and postoperative proliferative vitreoretinopathy. Abstract : Purpose: To determine the incidence of and identify risk factors for redetachment in eyes that underwent rhegmatogenous retinal detachment (RRD) repair after infectious endophthalmitis. Methods: Retrospective chart review of patients who had RRD surgery following a diagnosis of endophthalmitis from 2008 to 2021 at a tertiary referral center. Demographic and clinical characteristics as well as operative details were collected. Subjects with prior RRD, trauma, keratoprosthesis, or less than 3 months of postoperative follow-up were excluded. Univariate logistic regression analyses were performed. Results: Thirty-four eyes of 34 patients were included. Most subjects were male with a mean age of 60.1 years. Exogenous (58.8%) was more common than endogenous (41.2%) sources of endophthalmitis. Seventeen of 34 eyes (50.0%) experienced redetachment. Significant risk factors were infection with virulent organisms, hypotony, and postoperative proliferative vitreoretinopathy. Initial management with vitreous tap or vitrectomy, exogenous versus endogenous source, and surgical procedure were not associated with recurrent RRD. At the final follow-up, 32 of 34 eyes (91.2%) were attached, although more than one third of these had silicone oil. Conclusion: Redetachment occurred in half of eyes that underwent surgical repair of RRD after endophthalmitis. Early vitrectomy, with or without prior vitreous tap, was not associated with a higher risk of redetachment and improved the likelihood of a positive culture result. Culture data can aid in risk stratification because organism virulence was a risk factor for recurrent RRD. Although visual outcomes were generally poor, most retinas remained attached at the final visit.