The Endophthalmitis Vitrectomy Study (EVS) published in the December issue of the Archives1 has helped greatly in establishing reasonable guidelines for the management of infectious postoperative endophthalmitis. However, 1 of the conclusions of the study, namely, that there was no difference in final visual acuity or media clarity whether or not systemic antibiotics were used, seems to not be entirely supported by the data.
Only 2 systemic antibiotics were used during the entirety of the study, namely, amikacin and ceftazidime hydrochloride. It is clear from the results of the study that the use of these 2 antibiotics intravenously did not alter the outcome of therapy. However, we do not believe that this study "puts to rest" as Dr Forster2 says in his accompanying Editorial, the question of the usefulness of all systemic antibiotics in the management of postoperative endophthalmitis. Many clinicians for the past several years have used
Haimann MH, Weiss H, Miller J. The Endophthalmitis Vitrectomy Study. Arch Ophthalmol. 1996;114(8):1025. doi:10.1001/archopht.1996.01100140233030