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May 2001

Management of Endophthalmitis in the Post–Endophthalmitis Vitrectomy Study Era

Arch Ophthalmol. 2001;119(5):754-755. doi:10.1001/archopht.119.5.754

IN 1995, the Endophthalmitis Vitrectomy Study (EVS) Group1 published the results of a multicenter randomized clinical trial evaluating the roles of pars plana vitrectomy and systemic antibiotics in the management of postcataract extraction endophthalmitis. The article demonstrated that immediate vitrectomy was not necessary in patients with visual acuity better than light perception at the time of presentation, but that it was of significant benefit for those with light perception only. In addition, the use of systemic antibiotics did not enhance final visual acuity or media clarity. As a result, the EVS has had a significant effect on the management of postcataract surgery endophthalmitis. Most patients are now treated in the office with vitreous tap and intravitreal antibiotic injection rather than pars plana vitrectomy, and most can now be managed as outpatients and do not require hospitalization with intravenous (IV) antibiotics.

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