Subject(s)
Astrocytes/pathology , Hamartoma/complications , Macula Lutea , Optic Disk , Optic Nerve Diseases/complications , Retinal Detachment/complications , Retinoschisis/complications , Hamartoma/pathology , Humans , Male , Optic Nerve Diseases/pathology , Retinal Detachment/surgery , Retinoschisis/surgery , Vitrectomy , Young AdultABSTRACT
PURPOSE: The clinical features and visual prognosis after vitrectomy for endophthalmitis which had developed after cataract surgery were compared in two groups with or without background factors, including malignant tumor, diabetes, oral steroid administration, collagen disease, dacryocystitis, and lid closure disturbance. METHOD: Fifty-two patients (53 eyes) who underwent a vitrectomy for the treatment of endophthalmitis which had developed within 6 weeks after cataract surgery. They were divided into two groups according to the presence (21 eyes, group A) or absence (32 eyes, group B) of background factors, and were retrospectively compared based on their medical records. RESULTS: The culture-positive rate was 62% in group A and 69% in group B. The incidence of a final visual acuity of more than 20/20 was significantly lower in group A (14%) than in group B (47%, p < 0.05). Methicillin-resistant Staphylococcus aureus, alpha-hemolytic Streptococcus and Enterococcus were frequently identified in group A. Leakage from the cataract wound was found in about 80% of the patients with corneal incisions, and a wound that had not been covered by the conjunctiva was significantly more frequent as a factor in group A (group A, 13 eyes; group B, 10 eyes; p < 0.05). CONCLUSION: Postoperative endophthalmitis may have a less favorable visual prognosis in patients with background factors, so precise wound construction during cataract surgery is important in these patients.
Subject(s)
Cataract Extraction , Endophthalmitis/surgery , Postoperative Complications/surgery , Adrenal Cortex Hormones , Adult , Aged , Aged, 80 and over , Collagen Diseases , Diabetes Mellitus , Endophthalmitis/microbiology , Endophthalmitis/physiopathology , Female , Humans , Male , Methicillin Resistance , Middle Aged , Neoplasms , Prognosis , Retrospective Studies , Staphylococcus aureus/isolation & purification , Visual Acuity , VitrectomyABSTRACT
A 63-year-old man presented with a foveal detachment and retinoschisis associated with myopic traction maculopathy of his left eye with a refractive error of -12.0 dioptres. Both the retinoschisis and foveal detachment were initially successfully treated with vitreous surgery that was limited to the induction of a posterior vitreous detachment beyond the areas of retinoschisis over the posterior staphyloma. Three years later, the macula re-detached and further surgery was performed, which involved peeling the internal limiting membrane (ILM). Following the second vitreous surgery the macula reattached within one month of the surgery and this success has been sustained for 2 years, suggesting that peeling the ILM may be an effective treatment for recurrent myopic traction maculopathy.
