Author(s): Venkatesh P, Verma L, Tewari H
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Abstract Endophthalmitis following pars-plana procedures such as a vitrectomy vitreo-retinal procedures has been infrequently reported in literature. The cited incidence is about 0.1\% to 0.2\%. In the 8 cases of endophthalmitis that have been reported in literature, the prognosis has been indicated as very poor due to a delay in diagnosis (1-3). Also, no possible source of an inoculum of the pathogenic organism reaching the vitreous cavity has been considered in these reports. We have encountered a few cases of endophthalmitis following vitreo-retinal surgeries at our tertiary eye care centre. Here again not being able to identify the possible source of infectious spread, we now report for the first time in literature, a new entity, the 'posterior vitreous wick syndrome'. This potential source of infectious spread, to the best of our knowledge, has not been considered earlier. We describe the patho-mechanism of the 'posterior vitreous wick syndrome' and also suggest methods of reducing its occurrence during vitreo-retinal procedures. This could also be the patho-mechanism of endophthalmitis following inadvertent loss of scleral integrity during extraocular surgeries like retinal detachment surgery and strabismus surgery (4,5).
This article was published in Med Hypotheses
and referenced in Optometry: Open Access