O. Maneschg

Spectral domain optical coherence tomography in patients after successful management of postoperative endophthalmitis following cataract surgery by pars plana vitrectomy

BackgroundAcute severe postoperative endophthalmitis may lead to severe vision loss. The aim of this study was the analysis of macular microstructure imaged by spectral domain optical coherence tomography in patients after pars plana vitrectomy due to postcataract endophthalmitis.MethodsA cross sectional study was carried out in 17 patients who had cataract surgery in both eyes and underwent unilateral pars plana vitrectomy due to postcataract endophthalmitis. Postoperative best corrected visual acuity was determined in both eyes. Evaluation of macular thickness, macular volume, peripapillary retinal nerve fiber layer thickness and choroidal thickness using enhanced depth imaging technique was performed by spectral domain optical coherence tomography. The measurements obtained in the operated eye were compared to the fellow eye by Wilcoxon matched pair test. Correlation test was performed by Spearman rank order.ResultsA mean postoperative best corrected visual acuity of 63 ± 30 ETDRS letters versus 75 ± 21 letters was achieved in the study and fellow eyes, respectively, after a mean of 5.3 ± 4.5 months (p = 0.1). The mean macular thickness was 320.6 ± 28.8 μm SD in the study eyes compared to 318.4 ± 18.8 μm in the fellow eyes (p = 0.767). No differences were noted in macular volume (p = 0.97) and in peripapillary retinal nerve fiber layer thickness (p = 0.31). Choroidal thickness was significantly lower in the study eyes compared to the fellow eyes (p = 0.018). Epiretinal membrane was found in 7 eyes after endophthalmitis, while in the fellow eyes only in 3 cases (p = 0.13, Fisher’s exact test).ConclusionChoroidal thickness decreased significantly after endophthalmitis, but there was no functional correlation with the changes in choroidal microstructure. The development of epiretinal membranes may be associated with either vitrectomy or endophthalmitis in the history. Absence of other significant structural and morphological findings shows that successful treatment may guarantee good clinical results even in long term after this severe postoperative complication.

[Ultrasonographic findings in endophthalmitis following cataract surgery : a review of 81 cases].

PURPOSE Review and analysis of ultrasonographic data of patients with endophthalmitis following cataract surgery. PATIENTS AND METHODS We conducted a retrospective analysis of data and ultrasound findings of 81 patients with endophthalmitis following cataract surgery between 2000 and 2005. We evaluated the type of surgery, time of onset of endophthalmitis, and different ultrasonographic findings. RESULTS During the study period, acute endophthalmitis following cataract surgery developed in 41 eyes, subacute endophthalmitis in 25 eyes, and late-developing endophthalmitis in 20 eyes. In 51% of the cases, the endophthalmitis occurred after the phacoemulsification method. Ultrasonographic findings such as membrane formation were found in 23 eyes (28%), and dense vitreous opacities were detected in nine eyes. Posterior wall thickness was measured in 73 eyes. Two initial echography findings were associated with acute and subacute endophthalmitis: dense vitreous opacities and detachment of the posterior vitreous limiting membrane. CONCLUSION Ultrasonographic findings such as increased thickness of the posterior wall and dense organization of the vitreous can be useful in the clinical evaluation, prediction, and treatment of postoperative endophthalmitis.

Ultrasonographische Befunde bei Endophthalmitis nach Kataraktoperationen

PURPOSE Review and analysis of ultrasonographic data of patients with endophthalmitis following cataract surgery. PATIENTS AND METHODS We conducted a retrospective analysis of data and ultrasound findings of 81 patients with endophthalmitis following cataract surgery between 2000 and 2005. We evaluated the type of surgery, time of onset of endophthalmitis, and different ultrasonographic findings. RESULTS During the study period, acute endophthalmitis following cataract surgery developed in 41 eyes, subacute endophthalmitis in 25 eyes, and late-developing endophthalmitis in 20 eyes. In 51% of the cases, the endophthalmitis occurred after the phacoemulsification method. Ultrasonographic findings such as membrane formation were found in 23 eyes (28%), and dense vitreous opacities were detected in nine eyes. Posterior wall thickness was measured in 73 eyes. Two initial echography findings were associated with acute and subacute endophthalmitis: dense vitreous opacities and detachment of the posterior vitreous limiting membrane. CONCLUSION Ultrasonographic findings such as increased thickness of the posterior wall and dense organization of the vitreous can be useful in the clinical evaluation, prediction, and treatment of postoperative endophthalmitis.

Erratum zu: Genauigkeit und Relevanz der CT-Volumetrie bei offenen Bulbusverletzungen mit intraokularen Fremdkörpern

Hintergrund/Zielsetzung Es erfolgte die Ausarbeitung der radiologischen Daten mittels CT-Volumetrie und der klinischen Ergebnisse bei offenen Augenverletzungen mit intraokularen Fremdkorpern.

Hornhaut Konfokal-Mikroskopie bei einer bilateralen Augenverletzung mit multiplen kornealen Fremdkörpern@@@Confocal microsopy after multiple corneal foreign body injury

SummaryBACKGROUND: To analyse the morphological alterations, epithelial, inflammatory and Langerhans cell density of cornea after longstanding bilateral multiple corneal metal foreign body (FB) injury. PATIENT AND METHODS: Clinical records of a 36 years male patient were reviewed and confocal microscopy was performed two and six years after injury. RESULTS: Corneal FBs were situated in 10–156 μm depth. The wing cells were enlarged around FBs (3564 ± 95/mm2) on visit 1, but their size decreased by visit 2 (3962 ± 71/mm2). No inflammatory cell could be detected while Langerhans cells were randomly seen around FBs (28 ± 3/mm2 on visit 1, and 38 ± 4/mm2 on visit 2 respectively). Subbasal nerves were gracile, fragmented around FBs on visit 1, and remained altered on visit 2. CONCLUSIONS: Our observation may prove that the corneal immune system can tolerate stable intracorneal metal FBs. The longstanding morphological alterations of epithelial cells and subbasal nerves mark the complex impact that such injury can cause.ZusammenfassungHINTERGRUND: Auswertung der morphologischen Unterschiede, Epithel-, Entzündungs- und Langerhanssche Zellen nach einer langjährigen bilateralen Verletzung mit multiplen Metall-Fremdkörpern. PATIENT UND METHODE: Die Augen von einem 36-jährigen männlichen Patienten wurden mit in vivo Konfokalmikroskopie 2 Jahre (Visite 1) bzw. 6 Jahre (Visite 2) nach eine bilateralen Gasofenexplosion Hornhautverletzung untersucht. ERGEBNISSE: Die Fremdkörper lagen zwischen 10–156 Mikrometer Tiefe. Die Flügelzellendichte betrug bei Visite 1 in Fremdkörpernähe (rechtes Auge (RA): 3564±95/mm2, linkes Auge (LA): 3624±73/mm2), bei Visite 2 zeigte sich aber eine Größen-Abnahme, bzw. eine Zunahme der Dichte (RA: 4121±69/mm2, LA: 3962±71/mm2). Keine Entzündungszellen waren zu erkennen, während Langerhanssche Zellen zufällig um die Fremdkörper verteilt waren (RA:26±4/mm2, LA: 30±7/mm2 bei Visite 1 und RA: 37±4/mm2, LA: 39±5/mm2 bei Visite 2). Subbasale Nerven waren in der Nähe der Fremdkörper dünn verteilt. SCHLUSSFOLGERUNG: Unsere Beobachtungen zeigen, dass das Immunsystem der Hornhaut stabile intrakorneale Fremdkörper vertragen kann. Die langdauernden, morphologischen Veränderungen der Epithelzellen und der subbasalen Nerven zeigen den komplexen Heilungsprozeß der Hornhaut nach einer solchen Verletzung.

Erratum zu: Hornhaut Konfokal-Mikroskopie bei einer bilateralen Augenverletzung mit multiplen kornealen Fremdkörpern

SummaryBACKGROUND: To analyse the morphological alterations, epithelial, infammatory and Langerhans cell density of cornea after longstanding bilateral multiple corneal metal foreign body (FB) injury. PATIENT AND METHODS: Clinical records of a 36 years male patient were reviewed and confocal microscopy was performed two and six years after injury. RESULTS: Corneal FBs were situated in 10–156 μm depth. The wing cells were enlarged around FBs (right eye (RE): 3564±95/ mm2, left eye (LE): 3624±73/mm2) on visit 1, but their size decreased by visit 2 (RE: 4121±69/mm2, LE: 3962±71/mm2). No inflammatory cell could be detected while Langerhans cells were randomly seen around FBs (RE: 26±4/mm2, LE: 30±7/ mm2 on visit 1, and RE: 37±4/mm2, LE: 39±5/mm2 on visit 2 respectively). Subbasal nerves were gracile, fragmented around FBs on visit 1, and remained altered on visit 2. CONCLUSION: Our observation may prove that the corneal immune system can tolerate stable intracorneal metal FBs. The longstanding morphological alterations of epithelial cells and subbasal nerves mark the complex impact that such injury can cause.

Ultrasonographische Befunde bei Endophthalmitis nach Kataraktoperationen@@@Ultrasonographic findings in endophthalmitis following cataract surgery: Rückblick auf 81 Fälle@@@A review of 81 cases

PURPOSE Review and analysis of ultrasonographic data of patients with endophthalmitis following cataract surgery. PATIENTS AND METHODS We conducted a retrospective analysis of data and ultrasound findings of 81 patients with endophthalmitis following cataract surgery between 2000 and 2005. We evaluated the type of surgery, time of onset of endophthalmitis, and different ultrasonographic findings. RESULTS During the study period, acute endophthalmitis following cataract surgery developed in 41 eyes, subacute endophthalmitis in 25 eyes, and late-developing endophthalmitis in 20 eyes. In 51% of the cases, the endophthalmitis occurred after the phacoemulsification method. Ultrasonographic findings such as membrane formation were found in 23 eyes (28%), and dense vitreous opacities were detected in nine eyes. Posterior wall thickness was measured in 73 eyes. Two initial echography findings were associated with acute and subacute endophthalmitis: dense vitreous opacities and detachment of the posterior vitreous limiting membrane. CONCLUSION Ultrasonographic findings such as increased thickness of the posterior wall and dense organization of the vitreous can be useful in the clinical evaluation, prediction, and treatment of postoperative endophthalmitis.