The Management of Endophthalmitis Following Cataract Extraction

Intraocular infection is perhaps the most dreaded of all the complications which may follow cataract extraction. When endophthalmitis is associated with a vitreous abscess, the chances of a successful end-result becomes very poor indeed. The introduction of modern chemotherapeutic and antibiotic agents has somewhat improved the outlook in these conditions in recent years, but intraocular infection has not yet become a complication to be viewed with equanimity. Clinical and Experimental Observations Between 1944 and 1948 occasional reports were published of the successful management of endophthalmitis by the sulfonamides and penicillin.¹⁻⁴The successes, however, were few, and the outlook was not hopeful. The sulfonamides apparently penetrate the blood-aqueous barrier satisfactorily, but their narrow antibacterial spectrum limits their field of usefulness. In 1944, von Sallmann and Meyer⁵demonstrated that penicillin, even when given systemically in massive doses, does not penetrate sufficiently into the vitreous to produce concentrations adequate to control