The Endophthalmitis Vitrectomy Study

Most cases of endophthalmitis (70%) occur as a complication of intraocular surgery.1The incidence of endophthalmitis varies, but it is generally reported to occur after 0.1% to 0.4% of cataract operations,2-5and the vast majority of cases (88%) occur within 6 weeks of surgery.6Despite measures believed to decrease the incidence of infection, such as microsurgical wound closure, perioperative antibiotic injections, and preservation of an intact posterior capsule, postoperative endophthalmitis continues to occur, and current management still leaves many eyes with only poor vision. In the not too distant past, conventional treatment of bacterial endophthalmitis consisted of intravenous, subconjunctival, and topical antibiotics. Visual results with this approach were poor, with visual acuity of only hand motions or worse in 67% to 96% of cases.5,7-9Studies showing poor intravitreal antibiotic penetration by these routes led to trials using direct injection of antibiotics into the vitreous. It was