Incidence of endophthalmitis after 20-gauge vs 23-gauge vs 25-gauge pars plana vitrectomy. 2011

Ingrid U Scott, and Harry W Flynn, and Nur Acar, and Sundeep Dev, and Saad Shaikh, and Robert A Mittra, and J Fernando Arevalo, and Andres Kychenthal, and Allen Kunselman
Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, 500 University Drive, HU19, Hershey, PA 17083-0850, USA. iscott@psu.edu

OBJECTIVE To compare endophthalmitis rates after 20-gauge versus 23-gauge versus 25-gauge pars plana vitrectomy (PPV) in 2007-2008, and compare the rates with those of 2005-2006. METHODS Multicenter study including all patients who developed endophthalmitis following PPV performed by any of the authors during 2005-2008, and all patients who developed endophthalmitis following PPV at Penn State College of Medicine and Bascom Palmer Eye Institute during 2005-2008. The endophthalmitis rates after 20-gauge, 23-gauge and 25-gauge PPV during 2007-2008 were compared to those from 2005-2006. RESULTS The endophthalmitis incidence during 2007-2008 was 1/4,403 (0.02%) for 20-gauge PPV, 1/3,362 (0.03%) for 23-gauge PPV, and 1/789 (0.13%) for 25-gauge PPV. There is no significant difference among these rates between any two of the three groups. Compared with the endophthalmitis rates among the same group of surgeons during 2005-2006, the 2007-2008 endophthalmitis rates following 20-gauge and 23-gauge PPV were stable, and the rate following 25-gauge PPV was marginally lower (p = 0.056; odds ratio = 0.15; 95% CI: (0.003, 1.03)). CONCLUSIONS There was no significant difference in the 2007-2008 rates of endophthalmitis following 20-gauge versus 23-gauge versus 25-gauge PPV; among the same group of surgeons, the 2007-2008 rate of endophthalmitis following 25-gauge PPV was marginally lower than the 2005-2006 rate.

UI MeSH Term Description Entries
D008297 Male Males
D008866 Microsurgery The performance of surgical procedures with the aid of a microscope.
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009877 Endophthalmitis Suppurative inflammation of the tissues of the internal structures of the eye frequently associated with an infection. Ophthalmia,Infectious Endophthalmitis,Endophthalmitides,Endophthalmitides, Infectious,Endophthalmitis, Infectious,Infectious Endophthalmitides,Ophthalmias
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012163 Retinal Detachment Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). Retinal Pigment Epithelial Detachment,Detachment, Retinal,Detachments, Retinal,Retinal Detachments
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012167 Retinal Perforations Perforations through the whole thickness of the retina including the macula as the result of inflammation, trauma, degeneration, etc. The concept includes retinal breaks, tears, dialyses, and holes. Macular Holes,Retinal Breaks,Retinal Dialyses,Retinal Holes,Retinal Tears,Break, Retinal,Breaks, Retinal,Dialyses, Retinal,Hole, Macular,Hole, Retinal,Holes, Macular,Holes, Retinal,Macular Hole,Perforation, Retinal,Perforations, Retinal,Retinal Break,Retinal Dialyse,Retinal Hole,Retinal Perforation,Retinal Tear,Tear, Retinal,Tears, Retinal

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