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22. Kongress der DGII 2008
Abstracts DGII 2008
KV96
Management of low grade endophthalmitis
by capsular bag irrigation
Schlichtenbrede F
Universitäts-Augenklinik Mannheim
Aims: Further to topical or intravitreal antibiotics treatment of low
grade endophthalmitis (lg-E) usually comprises either pars plana
vitrectomy (ppv), capsulectomy or intraocular lens (IOL) removal.
Sequestration of microorganisms in the capsular bag (CB) renders
intensive antibiotics ineffective. Hence, removal or irrigation of the
CB as nidus is curative. Here, we report on CB irrigation as an alternative
procedure. Methods: We included 11 patients presenting
with whitish precipitates in the CB, anterior chamber inflammation
and vitreous body cells 2 days to 10 months after standard cataract
surgery with IOL implantation. The CB was irrigated with 30 ml of
Ringer’s solution containing 0.12 mg/ml gentamicin and 0.03 mg/ml
vancomycin in topical anaesthesia. Via a 1-mm paracentesis an irrigation
needle was introduced into the anterior chamber, circular
adhesions between capsulorhexis and the IOL were opened, and
the IOL was rotated within the intact CB. Results: In all patients,
the inflammation subsided within 2 days to 3 weeks. Visual acuity
improved in all cases, with improvement from counting fingers to
0.8 as best results. During the follow-up period of more than 1,5
years visual acuity remained stable. Conclusions: Our results suggest
that antibiotic irrigation of the CB and IOL as minimally invasive
procedure may be an alternative in the in the surgical management
of postoperative lg-E.
Erschienen in: Klin Monatsbl Augenheilkd 2008; 225: Suppl 1, S1–S24 |
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