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Diagnostic pars plana vitrectomy report of a 21-year retrospective study Palexas GN; Green WR; Goldberg MF; Ding YTrans Am Ophthalmol Soc 1995[]; 93 (ä): 281-308; discussion 308-14PURPOSE: To review the experience of diagnostic pars plana vitrectomies (PPV). METHODS: The authors reviewed 405 consecutive diagnostic PPV's performed between November 1973 and October 1994. RESULTS: Diagnostic vitrectomy was performed in 215 (53%) of 405 eyes for suspected endophthalmitis. Of those 215 cases, acute inflammation was confirmed in 62 (28.8%), 60 (27.9%) had microbial organisms present and 36 (16.7%) were culture-positive. Microbial organisms were observed microscopically in 31 (20%) of 156 patients suspected of postoperative endophthalmitis. Of those 31 cases, 23 (74%) were gram-positive, eleven (37%) of 30 eyes had organisms associated with glaucoma filtering procedures and 20 (16%) of 126 eyes had organisms with non-filtering procedures. The pooled percentage of eyes that developed postoperative endophthalmitis as a complication during the period July 1990 thru June 1994 is 5 (0.046%) out of a heterogeneous group of 10,898 cases operated on at the Wilmer Eye Institute for cataract, glaucoma, corneal transplant, pars plana vitrectomy and retinal detachment. Bacteria were identified microscopically in 6 (18%) of 34 post-traumatic cases. Microbial organisms were identified in 23 (92%) of 25 cases with an endogenous infection. Patients with endogenous infections had the most fungal infections, and the majority were in males. Neoplasms were diagnosed in 58 (14%) of the 405 cases. The most common neoplasm was ocular lymphoma 42 (72%), 69% of which were in females. Only 42 (48.3%) of 87 patients clinically suspected of having ocular lymphoma, actually had ocular lymphoma. Those negative for lymphoma were significantly older (67.4 +/- 10 years) compared to those with lymphoma (60.4 +/- 14 years) (P = 0.01). CONCLUSION: Diagnostic PPV has proved to be valuable in confirming and establishing various clinical diagnoses.|*Vitrectomy[MESH]|Acute Disease[MESH]|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Child[MESH]|Child, Preschool[MESH]|Endophthalmitis/*diagnosis/etiology/surgery[MESH]|Eye Infections/diagnosis/microbiology/surgery[MESH]|Eye Injuries/diagnosis/etiology[MESH]|Eye Neoplasms/diagnosis/etiology[MESH]|Female[MESH]|Humans[MESH]|Incidence[MESH]|Infant[MESH]|Male[MESH]|Middle Aged[MESH]|Postoperative Complications/diagnosis/microbiology[MESH]|Retrospective Studies[MESH]|Vitreous Body/microbiology/*pathology[MESH] |
