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You Have Got Endophthalmitis! What Next…???

The purpose of this presentation is to highlight significant worldwide issues in relation to Endophthalmitis management. It explores a detailed answer to this question – “What has changed since EVS?”; and highlights profound limitations of EVS, New evidences since EVS and Current Global Retina-Practice-Trends. The author unreservedly defends the role of early or primary vitrectomy in the management of most cases of Endophthalmitis;...

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Endophthalmitis After Intravitreal Drug Injection – A Transatlantic Controversy Regarding Prophylaxis and Treatment

Intravitreal drug application (IVI) has become the most frequent invasive intraocular procedure. Endophthalmitis – although rare with an incidence of 0,04% per injection – is the most devastated complication. Looking back to the initial era of IVI, infectious rates were as high as after cataract surgery. In face of a significant increased individual cumulative risk, antiseptic measures have been introduced and resulted in a marked...

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Ten Consecutive Cases of Endophthalmitis After IVT of Bevacizumab

Purpose: The purpose of this study is to report 10 consecutive cases of endophthalmitis after intravitreal injection of bevacizumab (avastin; roche) obtained from a single batch. Methods: One vial of bevacizumab (100mg/4ml) was used to take 10 sterile injections and aplied in the same moment that was taken from the batch. Bevacizumab (1.25mg/0.05ml) was injected intravitreally into 10 eyes of ten patiens to treat diabetic macular edema,...

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Intravitreal Levoxacin as Initial Treatment of Acute Exogenous Endophthalmitis Before PPV

The authors declare no conflict of interest. Purpose: To report the efficacy of intravitreal levofloxacin as an initial treatment of acute exogenous endophthalmitis on the stage of transportation of the patients to the vitreoretinal department and before early pars plana vitrectomy (PPV). Methods: Thirty patients (34 eyes) with exogenous endophthalmitis were included to this prospective non-randomized study. Fourteen patients (41.2%) had...

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Endoscopy-guided 20G PPV in Severe Endophthalmitis: Literature Review & Report of 18 Cases

Objective: We aim to report the anatomical and functional outcomes after endoscopy-guided vitrectomy, in a series of severe endophthalmitis. We also aim to identify two different clinical presentation modes and to compare the outcomes. Patients & Methods: Retrospective case study, single center, all patients who underwent endoscopic vitrectomy 20ga (Endo optiks E4 system) for severe endophthalmitis were included. For each case, data...

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Endophthalmitis – Immediate Intravitreal Antibiotic Therapy Only is What We Should Do

The Endophthalmitis Vitrectomy Study (EVS) has recommended that intravitreal antibiotics should be the ‘‘standard of care’’ for acute endophthalmitis occurring after cataract surgery and that the benefit of early vitrectomy surgery is limited. However, with recent advances in vitrectomy surgery techniques, there has been an increased interest in performing early vitrectomy surgery to treat endophthalmitis in...

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Bilateral Simultaneous Branch Retinal Artery Occlusion by Septic Emboli in Klebsiella Pneumoniae Endogenous Endophthalmitis: A First Case Report

Ah Ran Cho_SCIENTIFIC POSTER 2015 A branch retinal artery occlusion (BRAO) by a septic embolus in bacterial endogenous endophthalmitis has not been previously reported. The authors present the first case of a patient with bilateral simultaneous BRAO by evident septic emboli as a complication of nephrogenic Klebsiella endophthalmitis. A 50 year-old Asian female with a history of type 2 diabetes mellitus transferred to a tertiary care...

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Efficacy & Effectiveness of Repeat Intravitreal Antibiotics & Dexamethasone Injections on Postcataract Endophthalmitis

Jung Ho Lee_SCIENTIFIC POSTER 2015 Purpose: To evaluate the efficacy and effectiveness of repeated intravitreal antibiotics and dexamethasone injection in postoperative cataract endophthalmitis. Design: Retrospective, intervention case series. Methods: Health records were retrospectively reviewed for twenty-four patients with postcataract endophthalmitis who performed pars plana vitrectomy and were able to follow-up more than 6 months from...

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Prevention of Endophthalmitis Following Intravitreal Anti-VEGF Injection

Vladimir Poposki_SCIENTIFIC POSTER 2015 Introduction: The endophthalmitis is a devastating complication of intravitreal injection (IVI) procedure. Topical antibiotics are used by consensus and protocol, because of supposed advantage of its use in the reduction of conjunctival bacterial growth. However, this benefit is controversial. Many studies concluded that they do not alter the incidence nor reduce the risk of endophthalmitis. Even...

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Keratoprosthesis & Vitrectomy in Endophthalmitis Involving Cornea

Endophthalmitis with Corneal Involvement is a very grave situation. The prospect of saving the eye is low. The effective Vitrectomy may not be possible due to poor visualization. Also the corneal involvement always make the perforation and auto-evisceration of the eye as a real possibility. The use of keratoprosthesis is a wonderful way to overcome all these obstacles. In this video, we showed how effective this instruments can be. The...

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Extreme Maneuvers in Endophthalmitis

In those patients requiring vitreoretinal surgery and presenting opacity or corneal irregularity that prevents proper display, the use of a temporary keratoprostheses (QPT) is currently the best option. The QPT, implemented after trepanation of the opaque cornea, vitreoretinal surgery allows a correct visualization of intraocular structures. Once the vitreo-retinal surgery has been completed, the keratoprosthesis is removed and placed...

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Repeated Vitrectomy for Pseudomonas Aeruginosa Endophthalmitis After Cataract Surgery

A seventy-two-year-old woman was referred for treatment of endophthalmitis after cataract surgery. She underwent vitrectomy and vitreous culture, thus indicating Psuedomonas aeruginosa infection. Inflammatory material couldn’t be fully removed due to hazy operative field because of severe corneal edema. Waiting for corneal clearance, second vitrectomy was performed to remove preretinal and subretinal membrane. The repeated...

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Surgical Treatment of Endophthalmitis Following Intraocular Surgery and Eye Trauma

Advantages: To report the results of 23G pars plana vitrectomy (PPV) with vancomycin in tapping in endophthalmitis following intraocular surgery and eye trauma. Methods: 31 patients were treated with 23G PPV (19 due to postoperative endophthalmitis and 12 due to posttraumatic endophthalmitis) with vancomycin in tapping. All patients received topical and intravenous broad-spectrum antibiotics. Silicone oil tamponade was used in 17 cases,...

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SD-OCT Findings in Acute Syphilitic Posterior Placoid Chorioretinopathy

Purpose:  To describe the appearance of Acute Syphilitic Posterior Placoid Chorioretinitis (ASPPC), a rare ocular manifestation of syphilis, on Spectral Domain-Optical Coherence Tomography (SD-OCT) both before and after treatment. Methods:  Ophthalmic examination, imaging studies, and SD-OCT scans of 30 eyes of 19 confirmed ASPPC cases were analyzed both at the time of presentation and at each follow-up visit. Standard treatment for...

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How to Treat an Endophtalmitis Secondary to a Blebitis?

Advantages: To treat an endophthalmis due to a blebitis and to restore the filtration function. Methods: Our surgical technique consists in: 180º superior conjunctival peritomy avoiding the conjunctiva around the scleral lamella, conjunctival dissection through the superior portion until the eye equator, vitrectomy, limbar superior corneal keratectomy, conjunctival dissection on the filtration lamellar sclera, conjuctival fixation at the...

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Outcomes of Eyes with Post-traumatic Endophthalmitis in Open Globe Injuries

Yaprak Banu Ünver*, Ziya Kapran, Nur Acar, Yapar Kucuksumer (Istanbul, Turkey) Advantages: To analyze the microbiological characteristics, anatomical and visual outcomes of eyes with post-traumatic endophthalmitis Methods: Medical records were reviewed of 47 patients with post-traumatic endophthalmitis at a single institution between 2001 and 2011. Pars plana vitrectomy was performed in 34 (72,3%) cases as a first treatment. All eyes were...

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Endophthalmitis Rate after Intravitreal Injections with or without Drape

Authors: Vasliki Kounali, Kyriaki Raptaki, Theoni Panagiotoglou,  Paraskevi Dakou, George Pappas,  Heraklion, Greece Advantages: To evaluate the necessity of using a drape during intravitreal injections. Methods: This was a prospective randomized controlled clinical trial. 1000 patients were randomly assigned in two groups. Group 1 with and group 2 without drape. The rest of the procedure followed the American Academy of Ophthalmology...

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Late-Onset Endophthalmitis after Cataract Extraction: Differential Diagnosis

Ruiz-Bilbao SM, Vázquez-Dorrego XM, Anglada-Escalona JR, Broc Iturralde L, Domingo Viñals M. Advantages: Late-onset postsurgical endophthalmitis are not always bacterial. Methods: Late-onset endophthalmitis is a rare complication of cataract surgery. Many times, they are initially treated as bacterial, and etiological diagnosis is only made after vitrectomy with intraocular lens extraction. We present two patients who underwent...

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Post Cataract Endophthalmitis Caused By Pseudomonas Aeruginosa

Naveenam S. Muralidhar, MD (Bangalore, India), Paul E. Tornambe, MD (Poway, CA), Hemanth Murthy, MD (Bangalore, India), Veena Hemanth, MD (Mysore, India) PURPOSE: Endophthalmitis due to Pseudomonas has been reported to have poor outcome. We present our results of managing this condition with good outcome. METHODS: A retrospective analysis of records of 16 eyes of 16 patients with acute post operative endophthalmitis following cataract...

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Outcome of Earlier Vitrectomy for Acute Post-operative Endophthamitis

Leah A Wittenberg, MD (Vancouver, Canada), I-Van Ho, Franzco, MBBS, Grad Dip (Clin (Vancouver, Canada), Mohammed K. Adenwalla, MD (Vancouver, Canada), Patrick E. Ma, OD, MD, FRCS(C) (Vancouver, Canada) PURPOSE: To determine the outcome of early vitrectomy for acute post-operative endophthalmitis. The primary outcome is Snellen visual acuity. Secondary outcomes include complications requiring secondary surgery. METHODS: Retrospective...

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Acute Onset Endophthalmitis: The Degree of Anterior and Posterior Segment Involvement, Their Relationship and the Significance for the Treatment

Spyridon Mourtzoukos, MD (Athens, Greece), Elias Feretis, MD PhD (Athens, Greece), Stamatina Kabanarou, MD, PhD (Athens, Greece), Tassos Anastasakis, MD (Athens, Greece), Georgios Morfis, MD (Athens, Greece), Christine Kourenti, MD (Athens, Greece), Stamatina Xrou, MD (Athens, Greece), Georgios Magouritsas, MD (Athens, Greece) PURPOSE: To evaluate in acute onset endophthalmitis a) if it is possible to classify the degree of the involvement...

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Microbiological Aspects of Acute Bacterial Endophthalmitis after Cataract Surgery

Valéria Gaál, MD (Pécs, Hungary), Zsuzsanna Szijarto (Pecs, Hungary), Ferenc Kilar, MD, PhD (Pécs, Hungary), Bela Kocsis, MD, PhD (Pécs, Hungary), Ildiko Kustos, MD, PhD (Pécs, Hungary) PURPOSE: Our purpose was to overview cases with postoperative endophthalmitis (POE) and to investigate the adhesive ability of bacteria, isolated from eyes. METHODS: We reviewed the medical records of all patients with acute bacterial POE following...

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Endophthalmitis Following Cataract Surgery (2000-2006) in a Teaching Hospital

Harry W. Flynn, Jr., MD (Miami, FL), John J. Miller, MD (Miami, FL), William E. Smiddy, MD (Miami, FL), Darlene Miller, MPH (Miami, FL) PURPOSE: To report the incidence, clinical settings and visual acuity outcomes of acute-onset endophthalmitis following cataract surgery. METHODS: In this retrospective, observational case series, annual cataract surgery statistics were determined by review of electronic surgical records. The clinical and...

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Surgical Management in Acute Endophthalmitis

Fréderic Rouberol, MD (Lyon, France), Christophe Chiquet, MD (Grenoble, France) SYNOPSIS Treatment of acute endophthalmitis includes intravitreal injection of antibiotics, and pars plana vitrectomy. The surgery is looked at from several angles: removal of inflammatory debris or membranes in the anterior segment, obtaining intraocular specimens sampling, different modes of visualization of the fundus during surgery. After presenting the...

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Current Antibiotic Resistance Profiles for Vitreous Isolates in Bacterial Endophthalmitis

Eric W. Fitz, MD (New York, NY), Shaw Mahendra, BS (New York, NY), Richard B. Rosen, MD (New York, NY), Ronald C. Gentile, MD (New York, NY) PURPOSE: Endophthalmitis remains one of the most devastating complications of ophthalmic surgery. Timely treatment with appropriate antibiotics is necessary to prevent severe loss of vision. This study reviews microbial antibiotic resistance profiles of culture positive isolates in...

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Bacterial Identification Using PCR in a Large Series of Acute Postcataract Endophthalmitis

Christophe Chiquet, (Grenoble, France), Pierre-Olivier Lafontaine, MD (Dijon, France), Pierre-Loic Cornut, MD (Lyon, France), Yvonne Benito, (Lyon, France), Karine Palombi, MD (Grenoble, France), Gilles Thuret, MD, PhD (Saint-etienne, France), Fréderic Rouberol (Lyon, France), Catherine Creuzot, MD (Dijon, France), Jean-Paul Romanet (Grenoble, France), Francois Vandenesch, MD, PhD (Lyon, France) PURPOSE: To improve identification and...

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Klebsiella Endogenous Endophthalmitis – An Asian Perspective

Bob Ching-Li Cheng, MD (Singapore, Singapore), Soon-Phaik Chee, FRCOphth (Singapore, Singapore), Kah Guan Au Eong, MBBS, FRCS (Singapore, Singapore) PURPOSE: To analyse the risk factors, clinical presentation and prognosis of Klebsiella Endogenous Endophthalmitis (KEE) in Singapore. METHODS: Retrospective, non-comparative case series looking at culture proven (KEE) cases seen in the Singapore National Eye Centre from 1986-2003. RESULTS: A...

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Early Vitrectomy for Acute Endophthalmitis Following Intravitreal Triamcinolone Acetonide Injection

Adiel Barak, MD (Tel Aviv, Israel), Anat Loewenstein, MD (Tel Aviv, Israel) PURPOSE: Infectious endophthalmitis following intravitreal triamcinolone injections (IVTA) can result in severe loss of vision when treated in a fashion similar to the endophthalmitis vitrectomy Study recommendations. We want to report outcomes of six eyes who developed acute postoperative endophthalmitis following IVTA and were treated with early vitrectomy and...

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Delayed Onset Outbreak of Toxic Anterior Segment Syndrome

Adiel Barak, MD (Tel Aviv, Israel), Anat Loewenstein, MD (Tel Aviv, Israel) PURPOSE: To report an episode of toxic anterior chamber syndrome that occured 8 days after uneventful cataract extraction and IOL implantation. METHODS: Retrospective study evaluated an episode of 7 cases of postoperative inflammation that occurred 8 days after cataract extraction with placement of the posterior chamber IOL. RESULTS: Eight patients (out of 13...

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Retrospective Analysis of All Cases of Endophthalmitis at a Tertiary Referral Center

Rajendra S. Apte, MD, PhD (St. Louis, MO), Humeyra Karacal, MD (St. Louis, MO) PURPOSE: To determine the incidence, etiology and visual outcomes of endophthalmitis in a large Universitybased retina practice. METHODS: 40,371 patients were seen at Barnes Retina Institute between 2000 and 2005, and 1,872 patients had intravitreal injections during same time period. 68 cases of endophthalmitis were identified and reviewed retrospectively for...

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Posttraumatic Endophthalmitis: Microbiology and Visual Outcomes

Emad B. Abboud, MD (Riyadh, Saudi Arabia), Abdulrahman. M Alomran, MD (Riyadh, Saudi Arabia), Ahmed Mokhtar Abuelasrar, MD, PhD (Riyadh, Saudi Arabia) PURPOSE: To identify the microbiological spectrum and establish the visual prognosis of posttraumatic endophthalmitis. METHODS: This is a retrospective, consecutive, interventional case series. The medical records were reviewed of all 67 consecutive patients with positive intraocular culture...

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Complete and Early Vitrectomy for Eyes with Postoperative Endophthalmitis

Ferenc Kuhn, MD, PhD (Birmingham, AL), Giampaolo Gini, MD (Prato, Italy) PURPOSE: Following recommendations in the Endophthalmitis Vitrectomy Study (EVS), vitrectomy for postoperative endophthalmitis is performed today only if visual acuity drops to light perception. The authors evaluated their results achieved by performing complete and early vitrectomy for these eyes. METHODS: The authors treat their patients with postoperative...

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25-gauge Vitrectomy Management of Severe Post-cataract Surgery Endophthalmitis

Flavio A. Rezende, MD, PhD (Rio de Janeiro, Brazil), Simone Alcântara, MD (Rio de Janeiro, Brazil), Luiz Gustavo T. Regis, MD (Rio de Janeiro, Brazil), Mônica Kickinger, MD (Rio de Janeiro, Brazil) PURPOSE: To report the preliminary results of 25-gauge transconjunctival sutureless vitrectomy (TSV-25) for the management of sereve post-cataract surgery endophthalmitis. METHODS: We conducted a prospective consecutive noncomparative study of...

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Early Onset Endophthalmitis Caused By Aspergillus Species Following Cataract Surgery

http://www.evrs.eu/medias/2006/congress/Early-Onset-Endophthalmitis-Caused-By-Aspergillus-Species-Following-Cataract-Surgery.swf Harry W. Flynn, Jr., MD (Miami, FL), David Callanan, MD (Arlington, TX), Ingrid U. Scott, MD, MPH (Hershey, PA), Timothy G. Murray, MD (Miami, FL), Karen W. Oxford, MD (San Francisco, CA), Bradley Bowman, MD (Dallas, TX) PURPOSE: To report a series of patients who developed early onset endophthalmitis caused by...

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Acute-onset Endophthalmitis Following Clear Corneal Cataract Surgery (1996–2005): Clinical Features, Microbiology and Visual Outcomes

http://www.evrs.eu/medias/2006/congress/Acute-onset-Endophthalmitis-Following-Clear-Corneal-Cataract-Surgery-(1996-2005):-Clinical-Features,-Microbiology-and-Visual-Outcomes.swf Geeta A. Lalwani, MD (Miami, FL), Harry W. Flynn, MD (Miami, FL), Carolyn D. Quinn, MD (Miami, FL), Janet L. Davis, MD (Miami, FL), Timothy G. Murray, MD (Miami, FL), William E. Smiddy, MD (Miami, FL), Philip J. Rosenfeld, MD, PhD (Miami, FL) PURPOSE: To report the...

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Endophthalmitis in the Newborn

http://www.evrs.eu/medias/2006/congress/Endophthalmitis-in-the-Newborn.swf Kristen L. Hartley (Miami, FL), Audina M. Berrocal, MD, FAC, (Miami, FL), Amy C. Schefler, MD (Miami, FL), Magaly Diaz- Barbosa, MD (Miami, FL), Nader Moinfar, MD (Orlando, FL) PURPOSE: To determine the incidence, etiology, and associated risk factors for the development of endophthalmitis in the newborn over a 4-year period in a neonatal intensive care...

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Prophylaxis of Acute Post-traumatic Bacterial Endophthalmitis with and without Intraocular Antibiotic Injection

Masoud Soheilian, MD (Tehran, Iran), Nasrin Rafati, MD (Tehran, Iran), Shahin Yazdani, MD (Tehran, Iran), Houshang Faghihi  Habibabadi, MD (Tehran, Iran), Mostafa Feghhi, MD (Tehran, Iran), Hossein A Shahriari, MD (Tehran, Iran), Mohammad Reza Mohebi, MD (Tehran, Iran), Niloufar Piri, MD (Tehran, Iran), Gholam A. Peyman, MD (New Orleans, LA) PURPOSE: To evaluate the efficacy of combined intraocular injection of gentamicin and clindamycin...

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Microbial Isolates and Sensitivities in Posterior-segment Intraocular Foreign Body (IOFB) Injuries: A 10-year Review

http://www.evrs.eu/medias/2006/congress/Microbial-Isolates-and-Sensitivities-in-Posterior-segment-Intraocular-Foreign-Body-(IOFB)-Injuries:-A-10-year-Review.swf Samuel B Barone, MD (New York, NY), Sean C. Lalin, MD (New York, NY), Mahendra Shah, MS (New York, NY), Steven A. McCormick, MD (New York, NY), Richard B. Rosen, MD (New York, NY), Ronald C. Gentile, MD (New York, NY) PURPOSE: Evaluate the incidence of endophthalmitis and/or...

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