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Shah PN, Mishra DK, Shanmugam MP, Agarwal M, Susvar P, Sen AC, Ramanjulu R, Dave V, Saravanan V, Kannan N, Sinha T, Sindal MD, Singh SR, Rajanna MK, Ayachit AG, Maitray A, Yadav NK, Balakrishnan D, Nigam E, Narula R, Khadar SMA, Atri N, Mittal S, Murthy H, Mahalingam PS, Pillai GS, Nagpal M, Walinjkar J, Gupta V, Kothari A. Incidence of post vitrectomy endophthalmitis in India - A multicentric study by VRSI study Group. Eye (Lond) 2023; 37:2915-2920. [PMID: 36754984 PMCID: PMC10516918 DOI: 10.1038/s41433-023-02430-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/22/2022] [Accepted: 01/27/2023] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION The incidence of post vitrectomy endophthalmitis (PVE) is reported to be between 0.02 and 0.84%. Resterilization of single use instruments is a common practice amidst developing countries to make it more affordable to the patients by reducing the cost of the surgery and also reduce the environmental hazard. The aim of our study is to evaluate the incidence of PVE amidst existing sterilization practices of reused instruments in multiple vitreoretinal centres in India. METHODOLOGY Centres with an endophthalmitis tracking system were invited to participate in a survey. Twenty-five centres were sent a questionnaire via email. The questionnaire included details about the institution, number of vitrectomies performed in a year, sterilization practices followed pre-operatively, intraoperatively and postoperatively, incidence of endophthalmitis and instrument reuse policies. RESULTS A total of 29 cases of endophthalmitis were reported out of the 47,612 vitrectomies performed across various centres. The mean incidence of endophthalmitis was 0.06%. There was no difference in the rates of endophthalmitis based on various pre-operative, intraoperative or postoperative prophylactic measures. Nearly 80% of the centres change most of the instruments after every case, while the rest reused. The mean number of times a cutter was being reused until discarded was 4.7. Nearly 76% followed a performance-based protocol, and the remaining 24% had a fixed protocol for the number of times an instrument can be reused before discarding it. CONCLUSION PVE rates are not significantly different in India despite the multiuse of single use instruments. The purpose of this paper is not to suggest an alternate protocol but to creating one in the future with these results in mind, to rationalise the use of single use instruments, make VR surgery more affordable and also have a positive impact on the carbon footprint of consumables in surgery.
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Affiliation(s)
| | | | | | | | | | - Alok C Sen
- Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | | | - Vivek Dave
- L V Prasad Eye Institute, Hyderabad, Telangana, India
| | | | | | | | - Manavi D Sindal
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India
| | - Simar Rajan Singh
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | | | | - Eesh Nigam
- Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India
| | | | | | | | | | - Hemanth Murthy
- Retina Institute Of Karnataka, Bengaluru, Karnataka, India
| | | | - Gopal S Pillai
- Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | | | - Jaydeep Walinjkar
- Aditya Jyot Eye Hospital (P) Limited (A Unit Of Dr Agarwals Eye Hospital), Mumbai, Maharashtra, India
| | - Vishali Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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