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EDITORIAL Management of Endophthalmitis in the Post–Endophthalmitis Vitrectomy Study Era N 1995, the Endophthalmitis Vitrectomy Study ocular infection with vitreous involvement to bleb- (EVS) Group published the results of a mul- associated endophthalmitis. ticenter randomized clinical trial evaluating When endophthalmitis appears early on, the spec- the roles of pars plana vitrectomy and sys- trum of organisms is similar to that seen in postcataract I temic antibiotics in the management of post- surgery: predominantly Staphylococcus epidermidis. A cataract extraction endophthalmitis. The article dem- similar spectrum is seen with blebitis, explaining why this onstrated that immediate vitrectomy was not necessary condition usually responds well to topical and systemic in patients with visual acuity better than light percep- antibiotic therapy. In the absence of definitive ocular in- tion at the time of presentation, but that it was of sig- volvement, neither vitreous cultures, intravitreal antibi- nificant benefit for those with light perception only. In otics, nor vitrectomy are necessary for blebitis. The vi- addition, the use of systemic antibiotics did not sual prognosis is generally quite good. However, most enhance final visual acuity or media clarity. As a result, cases of bleb-associated infections are delayed in onset, the EVS has had a
JAMA Ophthalmology – American Medical Association
Published: May 1, 2001
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