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December 1987

The Role of Vitrectomy in the Treatment of Postoperative Bacterial EndophthalmitisAn Experimental Study

Author Affiliations

From the Howe Laboratory of Ophthalmology (Ms Talley, Mr Casey, and Drs D'Amico and Talamo), the Retina Service (Dr D'Amico), and the Cornea Service (Dr Kenyon), Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston.

Arch Ophthalmol. 1987;105(12):1699-1702. doi:10.1001/archopht.1987.01060120097034

• While the diagnostic value of vitreous culture in the management of bacterial endophthalmitis is well established, the therapeutic value of vitrectomy in this condition is debated. The present experimental study uses an aphakic model of Staphylococcus aureus endophthalmitis in the rabbit. Animals were treated with the following: (1) intravitreal antibiotics alone; (2) intravitreal antibiotics with vitrectomy; (3) vitrectomy alone; and (4) no treatment. Eyes treated with antibiotics and vitrectomy displayed significantly clearer media at 14 days after therapy compared with eyes treated with antibiotics alone. There was also a greater tendency for eyes treated with antibiotics and vitrectomy to have negative cultures at 14 days, although this difference was not statistically significant. These findings are consistent with beneficial effects of therapeutic vitrectomy as an adjunct to intravitreal antibiotic therapy in an animal model of aphakic bacterial endophthalmitis.

Forster RK, Zachary IG, Cottingham AJ, et al:  Further observation on the diagnosis, cause, and treatment of endophthalmitis . Am J Ophthalmol 1976;81:52-56.
Peyman GA, Paque JT, Meisels HI, et al:  Postoperative endophthalmitis: A comparison of methods for treatment and prophylaxis with gentamicin . Ophthalmic Surg 1975;6:45-55.
Cottingham AJ, Forster RK:  Vitrectomy in endophthalmitis . Arch Ophthalmol 1976;94:2078-2081.Article
McGetrick JJ, Peyman GA:  Vitrectomy in experimental endophthalmitis: II. Bacterial endophthalmitis . Ophthalmic Surg 1979;10:87-92.
Driebe WT, Mandelbaum S, Forster RK, et al:  Pseudophakic endophthalmitis: Diagnosis and management . Ophthalmology 1986;93:442-448.Article
Puliafito CA, Baker AS, Haaf J, et al:  Infectious endophthalmitis . Ophthalmology 1982;89:921-929.Article
Forster RK, Abbott RL, Gelender H:  Management of infectious endophthalmitis . Ophthalmology 1980;87:313-319.Article
Diamond JG:  Intraocular management of endophthalmitis . Arch Ophthalmol 1981;99:96-99.Article
Rowsey JJ, Newsom DL, Sexton DJ, et al:  Endophthalmitis: Current approaches . Ophthalmology 1982;89:1055-1066.Article
Nelsen PT, Marcus DA, Bovino JA:  Retinal detachment following endophthalmitis . Ophthalmology 1985;92:1112-1117.Article
Brinton GS, Topping TM, Hyndiuk RA, et al:  Posttraumatic endophthalmitis . Arch Ophthalmol 1984;102:547-550.Article
Olson JC, Flynn HW, Forster RK, et al:  Results in the treatment of postoperative endophthalmitis . Ophthalmology 1983;90:692-699.Article
Bohigian GM, Olk RJ:  Factors associated with a poor visual result in endophthalmitis . Am J Ophthalmol 1986;101:332-334.
Talamo JH, D'Amico DJ, Hanninen LA, et al:  The influence of aphakia and vitrectomy on experimental retinal toxicity of aminoglycoside antibiotics . Am J Ophthalmol 1985;100:840-847.
Beyer TL, Vogler G, Sharma D, et al:  Protective barrier effect of the posterior lens capsule in exogenous bacterial endophthalmitis: An experimental primate study . Invest Ophthalmol Vis Sci 1984;25:108-112.