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Master Thesis

Facteurs de pronostic visuel des endophtalmies aiguës bactériennes post-chirurgie de cataracte

Abstract : Objective: To identify baseline clinical factors of visual prognosis in patients with acute endophthalmitis following cataract surgery. Methods : This prospective study included 99 patients. Factors related to the cataract surgery, the initial clinical presentation, and the microbiological diagnosis were analyzed based on the final visual outcome, defined as poor (<20/100) or good (≥20/40). Results: The significant baseline factors for good visual outcome (45% of the series) were the winter season, absence of complications during cataract surgery, initial visual acuity (VA), microbiological investigations revealing no microorganism or a coagulase-negative Staphylococcus sp. (CNS), and fundus visibility. Quantitative factors were shorter duration of cataract surgery, younger age, and a hypopyon equal to or less than 1.5 mm. Significant factors associated with poor visual outcome were infection of the right eye, initial VA, corneal edema, hypopyon larger than 1.5 mm, detection of bacterial species other than a CNS, and the absence of fundus visibility. Multiple logistic regression analysis showed that high bacterial virulence was the only independent factor (odds ratio [OR]= 14, p=0.001) for poor visual outcome. On the other hand, low bacterial virulence (OR=0.1, p=0.01) and the absence of complications (OR=0.07, p=0.003) during cataract surgery were independent factors for good VA. Conclusion: Visual outcome factors were similar to those reported by the EVS 10 years ago. The bacterial virulence level was the main predictive factor. This emphasizes the need for rapid bacterial identification and characterization using new biomolecular techniques.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00704867
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Submitted on : Wednesday, June 6, 2012 - 2:02:33 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM
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Aurélie Combey-De-Lambert. Facteurs de pronostic visuel des endophtalmies aiguës bactériennes post-chirurgie de cataracte. Human health and pathology. 2012. ⟨dumas-00704867⟩

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