Die bakterielle Endophthalmitis- Retrospektive Analyse über 10 Jahre an der UMG-Augenklinik

von Christoph Robert Polly
Dissertation
Datum der mündl. Prüfung:2023-07-05
Erschienen:2023-06-27
Betreuer:Prof. Dr. Nicolas Feltgen
Gutachter:Prof. Dr. Michael Weig
Gutachter:PD Dr. Sabine Sennhenn-Kirchner
Zum Verlinken/Zitieren: http://dx.doi.org/10.53846/goediss-9955

 

 

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Englisch

Bacterial endophthalmitis describes a rarely occurring intraocular inflammatory process, which is also one of the most serious diagnoses in ophthalmology. The cause of endophthalmitis is the spread of germs into the interior of the eye. This can occur during surgery, trauma, due to corneal migration, or by the endogenous route; via hematogenous seeding of an extraocular source of infection into the eye. The aim of this work was to analyze the endophthalmitis cases treated at the UMG Eye Clinic from 2010 to 2019. In conclusion, 182 cases were documented. 81.3% (n = 148/182) of the patients suffered postoperative endophthalmitis. Endophthalmitis occurred most frequently after lens surgery (37.9%; n = 69/182), followed by intravitreal surgical medication (IVOM) (24.7%; n = 45/182), after other surgeries such as peeling after gliosis surgery (14.8%; n = 27/182), or cerclage infections (3.8%; n = 7/182). 13.7% (n = 25/182) of cases suffered endophthalmitis due to endogenous causes and 2.7% (n = 5/182) due to trauma. Endophthalmitis after migration of a corneal infiltrate was diagnosed in 2.2% (n = 4/182). Over the 10-year period, 8 of 12,242 patients experienced endophthalmtis after lens surgery performed at the UMG Eye Clinic, an incidence of 0.0653%, consistent with values of 0.019%-0.2% reported in the literature. In an IVOM performed at the UMG Eye Clinic, endophthalmitis was diagnosed after 7 of 42,977 procedures. Over the period from 2010 to 2019, this translates to a rate of 0.016%. Again, the incidence is within the range of 0.009%-0.066% described by the literature. Thus, the two most common ophthalmic surgical procedures do not have an increased incidence at the UMG Eye Clinic when compared to the literature. However, in terms of pathogen detection, the detection rate of 48.9% (n = 86/176) was lower compared to other studies (up to 86%). As a result of this work an "endophthalmitis kit" was introduced into clinical routine in mid-2021 to improve the detection rate.
Keywords: Endophthalmitis
 
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