Our Summary

This study looks at two different treatments for endophthalmitis, an eye infection that can occur after a certain type of cataract surgery (phacoemulsification). The treatments are primary vitrectomy, a surgery where the jelly-like substance in the back of the eye is removed and replaced, and vitreous tap and antibiotic injection (T&I), where a sample of the jelly-like substance is taken and antibiotics are injected into the eye.

The study found that both treatments improved patients’ vision, but those who had the primary vitrectomy surgery saw a significantly greater improvement than those who had the T&I treatment. The study also found that a similar percentage of patients in both groups had bacteria in their eyes before treatment, but only those in the T&I group had bacteria in their eyes after treatment.

Additionally, more patients in the T&I group needed additional procedures compared to the vitrectomy group. On average, patients in the T&I group underwent 2.3 procedures each, while those in the vitrectomy group underwent 1.5.

In conclusion, the primary vitrectomy treatment was more effective at improving vision and sterilizing the eye, and required fewer procedures than the T&I treatment.

FAQs

  1. What is the difference between primary vitrectomy and vitreous tap and antibiotic injection (T&I) treatment for endophthalmitis?
  2. Based on the study, which treatment for endophthalmitis proved more effective in improving vision and sterilizing the eye?
  3. Did the study find that patients required fewer procedures with primary vitrectomy treatment compared to the T&I treatment?

Doctor’s Tip

A doctor might advise a patient considering vitrectomy to discuss the potential benefits and risks with their healthcare provider. They may also recommend following post-operative care instructions closely to ensure optimal recovery and vision outcomes.

Suitable For

Patients who are typically recommended vitrectomy are those with endophthalmitis, especially following cataract surgery. Vitrectomy may also be recommended for patients with other conditions such as retinal detachment, macular hole, diabetic retinopathy, and vitreous hemorrhage. Additionally, vitrectomy may be recommended for patients with severe eye trauma or intraocular foreign bodies.

Timeline

Before vitrectomy:

  1. Patient experiences symptoms of endophthalmitis, such as eye pain, redness, and decreased vision.
  2. Patient undergoes diagnostic tests to confirm the presence of the infection and determine the appropriate treatment.
  3. Patient discusses treatment options with their ophthalmologist, including the possibility of undergoing a vitrectomy surgery.

After vitrectomy:

  1. Patient undergoes the vitrectomy surgery, during which the jelly-like substance in the back of the eye is removed and replaced.
  2. Patient may experience some discomfort and blurry vision immediately following the surgery.
  3. Over the next few weeks, patient’s vision gradually improves as the eye heals.
  4. Patient attends follow-up appointments with their ophthalmologist to monitor their progress and ensure the infection has been successfully treated.
  5. Patient may need additional procedures or treatments if complications arise or if the infection recurs.

Overall, the timeline for a patient before and after vitrectomy involves a series of steps to diagnose, treat, and monitor the eye infection, with the goal of improving vision and preventing further complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vitrectomy include:

  1. What is the purpose of the vitrectomy procedure?
  2. What are the potential risks and complications associated with vitrectomy?
  3. How long is the recovery period after vitrectomy?
  4. What can I expect in terms of post-operative care and follow-up appointments?
  5. Are there any alternative treatments to vitrectomy that I should consider?
  6. How experienced are you in performing vitrectomy procedures?
  7. What is the success rate of vitrectomy for my specific condition?
  8. Will I need any additional treatments or procedures after the vitrectomy?
  9. How will vitrectomy affect my vision in the long term?
  10. Are there any lifestyle changes or precautions I need to take after vitrectomy?

Reference

Authors: Crosby NJ, Westcott M, Michael E, Cunningham WJ, Welch S, Polkinghorne PJ. Journal: Ocul Immunol Inflamm. 2022 Apr 3;30(3):727-733. doi: 10.1080/09273948.2020.1826539. Epub 2020 Oct 15. PMID: 33054484