Bacterial endogenous endophthalmitis in Vietnam: a randomized controlled trial comparing vitrectomy with silicone oil versus vitrectomy alone

Bacterial endogenous endophthalmitis in Vietnam: a randomized controlled trial comparing vitrectomy with silicone oil versus vitrectomy alone

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Tan Do,1 Do N Hon,1 Tin Aung,2 Nguyen DTN Hien,1 Claude L Cowan Jr3 1Vietnam National Institute of Ophthalmology, Hanoi, Vietnam; 2Singapore National Eye Center, Singapore; 3Georgetown University Medical Center, Washington, DC, USA Background/aims: To compare treatment outcomes with and without silicone oil tamponade in patients undergoing pars plana vitrectomy (PPV) for severe endogenous bacterial endophthalmitis (BEE).Methods: One hundred and eight consecutive patients with severe BEE (defined by the absence of pupil red reflex at presentation and/or dense vitreous opacity on ultrasound and no improvement after 24–36 hours of medical treatment) were randomly assigned to read more two treatment groups: Group 1, standard PPV with intravitreal antibiotics; and Group 2, PPV with intravitreal antibiotics and silicone tamponade.Overall success was defined as: a visual acuity ≥ count fingers at 1 meter, with an attached retina, and no intraocular oil.

Results: Fifty three patients were randomized to Group 1 and 55 patients to Group 2.The mean age of study subjects was 32 years and baseline clinical characteristics were similar in both groups.At the final follow-up visit at 9 months, the overall success rate of Group 2 (67.

3%) was significantly better than Group 1 (43.4%; P=0.01).

There were also fewer devastating complications (such as inoperable retinal detachment, phthisis bulbi) in Group 2 compared with Group 1 (21.8% versus 43.4%; P=0.

01).Conclusion: The outcome click here at 9 months of patients with BEE treated by vitrectomy with silicone oil was better than those treated by vitrectomy alone.Keywords: bacterial endogenous endophthalmitis, vitrectomy, silicone oil endotamponade, randomized controlled trial.