Primary Vitrectomy versus Tap and Inject for Fungal Endophthalmitis: Meta-Analysis and Comparison with Data from a Reference Centre

• Published in: Ocular immunology and inflammation 2024-07, Vol.32 (6), p.1-857
• Main Authors: Martínez-Pulgarin, Dayron F, Arias, Juan D, Córdoba-Ortega, Carlos M, Rangel, Carlos M, Varón, Clara L, Villareal, Eduardo, Villareal, Donaldo
• Format: Article
• Language: English
• ISSN: 0927-3948; 1744-5078; 1744-5078
• DOI: 10.1080/09273948.2024.2322026

We aimed to compare the visual outcomes after pars plana vitrectomy (PPV) versus tap and inject (T&I) in fungal endophthalmitis (FE) reported in the literature and to compare the findings from the literature with data from a reference centre. We performed a systematic review and meta-analysis of studies reporting the use of PPV versus T&I in FE. We also performed a retrospective review of the clinical records of patients with endophthalmitis from a reference centre in Colombia. We included 13 studies with 334 eyes; 53.59% received PPV and 46.4% received T&I. The overall relative risk of improving ≥ 2 lines in PPV versus T&I was 0.98 (95% confidence interval [CI] 0.80-1.22;  = 0.88) with a mean difference of final visual acuity of 0.26 (95% CI 0.12-0.63;  = 0.18). There were no significant differences in subgroup analysis. Data from the reference centre included 32 endophthalmitis cases, 15.6% of which had a fungal aetiology (80% received PPV and 20% T&I). There were no significant differences in the subgroup analysis. Based on the findings from the literature and the reference centre, T&I is noninferior to PPV. This is the first meta-analysis in the literature evaluating these effects in FE. It is necessary to execute new prospective randomised controlled studies in patients with endophthalmitis.