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#36395 Treatment of purulent endophthalmitis with pars plana vitrectomy under peribulbar block and conscious sedation
  1. Fernando Fernando Almeida e Cunha1,
  2. Daniela Fontes2,
  3. Marcos Pacheco2 and
  4. Daniela Simões1
  1. 1Serviço de Anestesiologia, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
  2. 2Serviço de Anestesiologia, Centro Hospitalar Entre Douro e Vouga , Santa Maria da Feira, Portugal


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Background and Aims Endophthalmitis is a severe intraocular inflammation that can occur following surgery or eye trauma. Wound infection has been described as a primary foci of infection in endogenous endophthalmitis. We present a case of purulent endophthalmitis treated with immediate pars plana vitrectomy (PPV) under peribulbar block and conscious sedation.

Methods A 75-year-old male patient, with multiple cardiovascular risk factors, underwent open aortic valve replacement, and was readmitted one month later with sternal wound infection. He received antimicrobial treatment. Four months later, the patient presented with purulent endophthalmitis. PPV ensued under peribulbar block and conscious sedation with a propofol perfusion. Peribulbar block was performed with two injections of Ropivacaine 1%: inferior-temporal (5mL) and superior-nasal (3mL), to ensure adequate spread within the intraconal and extraconal spaces.

Results Peribulbar anaesthesia allowed akinesia and good surgical conditions with respiratory and hemodynamic stability. The surgical procedure was performed successfully without perioperative complications.

Conclusions Peribulbar anaesthesia is a feasible anaesthetic technique for PPV, as it allows akinesia during surgery, better hemodynamic stability, and fewer postoperative complications, especially in older fragile patients with comorbidities. PPV performed under peribulbar block can be considered a reliable approach in managing purulent endophthalmitis, offering a safe alternative to general anaesthesia.

  • Peribulbar Block
  • Purulent Endophthalmitis
  • Pars Plana Vitrectomy
  • Conscious Sedation

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