Vitrectomy versus Intravitreal Antibiotic Injection to Treat Acute Endophthalmitis Developing after Cataract Surgery

ABSTRACT

PURPOSE: To compare the therapeutic efficacy of vitrectomy plus intravitreal antibiotic injection (vitrectomy group) with intravitreal antibiotic injection alone (antibiotic group) for eyes with acute endophthalmitis developed after cataract surgery with visual acuity of hand motion or better. METHODS: In this retrospective chart review, we compared the visual acuities of 10 eyes of a vitrectomy group and 17 eyes of an antibiotic group. RESULTS: We found no significant differences between the two groups in terms of age, comorbidities (diabetes, hypertension), time of symptom onset, time of diagnosis, type of systemic antibiotic prescribed, or positive culture rate. Mean baseline best-corrected visual acuity (BCVA) was similar in the two groups (2.17 vs. 1.96 logMAR; p = 0.60). Both groups exhibited significant improvements in mean BCVA after 2 months from 2.17 to 0.81 logMAR in the vitrectomy group (p = 0.01) and from 1.96 to 0.76 logMAR in the antibiotic group (p = 0.002), but the final BCVA did not differ significantly between the two groups (0.81 vs. 0.76 logMAR, p = 0.75). CONCLUSIONS: Both vitrectomy combined with intravitreal antibiotic injection and intravitreal antibiotic injection alone significantly improved visual acuity; the final BCVA did not differ between the two groups. Intravitreal antibiotic injection alone may be an effective first-line treatment for endophthalmitis in patients with initial visual acuity of hand motion or better.