New developments in the treatment of endophthalmitis

摘要

In spite of significant advances in endophthalmitis management over the past two decades, numerous unresolved issues remain. There is no doubt that approximately twenty years ago, the advent of intravitreal antibiotics paved the way for notably improved visual and anatomic outcomes. In the mid 1990s, the Endophthalmitis Vitrectomy Study (EVS) nicely addressed the role of vitrectomy versus vitreous tap in the treatment of postoperative endophthalmitis. The EVS provided. us with very important data regarding the pathogens which most commonly cause postoperative endophthalmitis (gram-positive organisms comprised 94.2% of isolates in the EVS (Fig. 1)). In addition, the EVS determined that there was no apparent benefit from the use of intravenous antibiotics (cephalosporins and amino-glycosides).1 The choice of systemic antibiotics in the EVS was the best available at the time, however, several studies after the completion of the EVS revealed that systemically administered cephalosporins and aminoglycosides don't achieve therapeutic intraocular concentrations in the vitreous cavity.