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. 2014 Oct;9(5):425-430.
doi: 10.1586/17469899.2014.951331. Epub 2014 Aug 23.

Update on the prevention and treatment of endophthalmitis

Stephen G Schwartz  1 , Harry W Flynn Jr  2
Affiliations

Update on the prevention and treatment of endophthalmitis

Stephen G Schwartz et al. Expert Rev Ophthalmol. 2014 Oct.

Abstract

Endophthalmitis remains a rare but serious cause of visual loss. Over time, changes have been noted in endophthalmitis in terms of predominant causes, infecting organisms, and antibiotic susceptibilities. There is controversy regarding the use of intracameral prophylactic antimicrobials during cataract surgery. Alternatively, there appears to be increasing evidence against using routine topical antibiotics for intravitreal injections. There are also increasing reports of multidrug-resistant organisms causing endophthalmitis, but the combination of vancomycin and ceftazidime appears effective for the vast majority of cases. Future trends may involve increasing utilization of polymerase chain reaction for diagnosis, and possibly office-based pars plana vitrectomy for treatment of endophthalmitis.

Keywords: Antibiotics; Endophthalmitis; Intravitreal injection; Pars plana vitrectomy; Polymerase chain reaction.

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Conflict of interest statement

Financial and competing interests disclosure

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1
Figure 1
1A. External photograph, right eye. A 73-year-old man presented with endophthalmitis following complicated cataract surgery. Visual acuity was light perception. The patient was treated with immediate pars plana vitrectomy and injection of intravitreal vancomycin, ceftazidime, and dexamethasone. Vitreous cultures were positive for coagulase-negative staphylococcus. 1B. External photograph, right eye. Following successful treatment, visual acuity 5 months after presentation was 20/50, limited by chronic cystoid macular edema. Note the distortion of the iris and the anterior chamber intraocular lens present.
Figure 1
Figure 1
1A. External photograph, right eye. A 73-year-old man presented with endophthalmitis following complicated cataract surgery. Visual acuity was light perception. The patient was treated with immediate pars plana vitrectomy and injection of intravitreal vancomycin, ceftazidime, and dexamethasone. Vitreous cultures were positive for coagulase-negative staphylococcus. 1B. External photograph, right eye. Following successful treatment, visual acuity 5 months after presentation was 20/50, limited by chronic cystoid macular edema. Note the distortion of the iris and the anterior chamber intraocular lens present.
See this image and copyright information in PMC

References

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