Results of the Endophthalmitis Vitrectomy StudyA Randomized Trial of Immediate Vitrectomy and of Intravenous Antibiotics for the Treatment of Postoperative Bacterial Endophthalmitis
Arch Ophthalmol. 1995 Dec;113(12):1479-96. Full text
Main finding: Routine immediate pars plana vitrectomy is not necessary in patients with better than light perception vision at presentation but is of substantial benefit for those who have light perception-only vision
Purpose: To determine the roles of immediate pars plana vitrectomy and systemic antibiotic treatment in the management of postoperative endophthalmitis.
Study type: Randomized controlled Trial
Condition: Post-operative endophthalmitis
Participants: endophthalmitis within 6 weeks after cataract surgery or secondary lens implantation
n=420
Intervention:
2×2 factorial design
Group 1: Immediate Vitrectomy + systemic antibiotics (Ceftrazidime and amikacin)
Group 2: Immediate Vitrectomy + placebo
Group 3: Vitreous tap/biopsy + systemic antibiotics (Ceftrazidime and amikacin)
Group 4: Vitreous tap/biopsy + placebo
There was no difference in final visual acuity or media clarity with or without the use of systemic antibiotics-
In patients with initial VA or HM or better, there was no difference in visual outcome with immediate VIT
In patients with initial LP only vision, immediate VIT produced:
3x increase of frequency of achieving VA 20/40 or better
2x chance of achieving VA 20/100 or better
50% decrease in frequency of severe visual loss
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