Maria Angeliaa*, Yufilia Suci Ameliab, Ivana Beatrice Albertac, Stefany Tantod, Kevin Gracia Pratamae
aDepartment of Emergency, Mitra Keluarga Kalideres Hospital, Jakarta, Indonesia, bDepartment of Emergency, Marianum Catholic Hospital, Halilulik, East Nusa Tenggara, Indonesia, cDepartment of Ophthalmology, Primasatya Husada Citra Hospital, Surabaya, Jawa Timur, Indonesia, dDepartment of Emergency, University of Pelita Harapan, Jakarta, Indonesia, eDepartment of Emergency, Fatima General Hospital, Ketapang Regency, West Kalimantan, Indonesia
Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation
Abstract
Endophthalmitis is a devastating eye complication that requires prompt and effective treatment. A pivotal study in the field of endophthalmitis treatment is the endophthalmitis vitrectomy study (EVS), conducted over a decade ago. The primary objective of this study was to assess the effectiveness of pars plana vitrectomy (PPV) as a treatment option for endophthalmitis following the EVS study. We conducted a comprehensive search across three databases: PubMed, EBSCO host, and ProQuest. Reference lists of published articles were searched. Our study encompassed research conducted between January 2013 and January 2023 to ensure the most up‑to‑date findings. The best‑corrected visual acuity (BCVA) in logMar, causative agents, and predicting factors for visual outcome were evaluated. Nine studies involving 351 eyes were included in the study; however, only eight were included in the meta‑analysis. We observed a significant BCVA improvement compared to baseline at 1 month, >1–3 months, >3–6 months, and ≥12‑month follow‑up, with mean differences of 1.06 (P < 0.001), 1.25 (P < 0.001), 1.41 (P < 0.001), and 1.01 (P < 0.001), respectively. A causative organism was cultured in 61.4% of cases, and the majority of them were Coagulase‑negative Streptococcus, Staphylococcus aureus, and Streptococcus sp. Factor associated with better visual acuity includes a younger age, lower intraocular pressure, and culture‑negative endophthalmitis. Meanwhile, culture‑positive endophthalmitis particularly Streptococcus sp., lower baseline vision, and presence of retinal detachment at initial presentation were identified as a prognostic for poorer visual outcome. PPV demonstrated a significant visual gain in patients with endophthalmitis in the 1st, 3rd, and 6th months. However, caution is warranted in drawing a definitive conclusion.
Keywords: Endophthalmitis, Pars plana vitrectomy, Postoperative endophthalmitis
