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December 1976

Vitrectomy in Endophthalmitis: Results of Study Using Vitrectomy, Intraocular Antibiotics, or a Combination of Both

Author Affiliations

From the Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine. Dr Cottingham is now at Fitzsimons General Hospital, Denver.

Arch Ophthalmol. 1976;94(12):2078-2081. doi:10.1001/archopht.1976.03910040738007

• A rabbit model of endophthalmitis was produced by inoculating Staphylococcus epidermidis and S aureus into the vitreous cavity. Elimination of microorganisms was compared using intravitreal administration of 0.1 mg of gentamicin alone, vitrectomy alone, and a combination of gentamicin and vitrectomy.

In the case of S epidermidis treated 24 hours after inoculation, all untreated eyes were culture-positive at one week, eyes treated with gentamicin alone or intravitreal gentamicin in combination with vitrectomy were all culture-negative, and vitrectomy alone rendered half of the eyes culture-negative.

In the case of S aureus, eyes not treated by vitrectomy alone were all culture-positive at one week. Eyes treated with intravitreal gentamicin 25 to 31 hours after infection were culture-negative for S aureus in 33% at one week, while eyes treated with combined vitrectomy plus intraocular gentamicin were culture-negative in 83% of cases. When treatment was delayed 40 to 49 hours after inoculation of S aureus, intravitreal gentamicin rendered 50% culture-negative at one week, while vitrectomy combined with intravitreal gentamicin eliminated the infection in 100% of eyes.

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