The peripheral vitreous is carefully shaved, but a complete vitreous removal must not be attempted since this significantly raises the risk of creating a retinal break
Consider using silicone oil tamponade
Organisms do not proliferate in the oil . Silicone oil use, however, is not a must; it should be preserved for those cases with major retinal pathology such as a break, detachment, or widespread necrosis, and then only if the vitreous cavity has been adequately cleaned.6 Antibiotics and corticosteroids should be placed into the infusion fluid (Table 2.17.3) and the vitreous/capsular bag/AC irrigated, then silicone oil injected
3 The capsules may be "dirty" from debris that settled on their surface; their "vacuuming" with the vitrectomy probe may be impossible without causing a capsular break.
4 i.e., not close to the eye wall/retina
5 Even in eyes with endophthalmitis persisting for several days, a vitreoschisis is more likely to be present than a true PVD. Leaving vitreous on the retinal surface increases the risk of macular injury from the organism's toxins, enzymes, and the body's inflammatory/immune response.
6 All pus and vitreous, except in the periphery, have been removed.
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