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The Role of Vitrectomy in the Treatment of Postoperative Bacterial Endophthalmitis: An Experimental Study

The Role of Vitrectomy in the Treatment of Postoperative Bacterial Endophthalmitis: An... Abstract • While the diagnostic value of vitreous culture in the management of bacterial endophthalmitis is well established, the therapeutic value of vitrectomy in this condition is debated. The present experimental study uses an aphakic model of Staphylococcus aureus endophthalmitis in the rabbit. Animals were treated with the following: (1) intravitreal antibiotics alone; (2) intravitreal antibiotics with vitrectomy; (3) vitrectomy alone; and (4) no treatment. Eyes treated with antibiotics and vitrectomy displayed significantly clearer media at 14 days after therapy compared with eyes treated with antibiotics alone. There was also a greater tendency for eyes treated with antibiotics and vitrectomy to have negative cultures at 14 days, although this difference was not statistically significant. These findings are consistent with beneficial effects of therapeutic vitrectomy as an adjunct to intravitreal antibiotic therapy in an animal model of aphakic bacterial endophthalmitis. References 1. Forster RK, Zachary IG, Cottingham AJ, et al: Further observation on the diagnosis, cause, and treatment of endophthalmitis . Am J Ophthalmol 1976;81:52-56. 2. Peyman GA, Paque JT, Meisels HI, et al: Postoperative endophthalmitis: A comparison of methods for treatment and prophylaxis with gentamicin . Ophthalmic Surg 1975;6:45-55. 3. Cottingham AJ, Forster RK: Vitrectomy in endophthalmitis . Arch Ophthalmol 1976;94:2078-2081.Crossref 4. McGetrick JJ, Peyman GA: Vitrectomy in experimental endophthalmitis: II. Bacterial endophthalmitis . Ophthalmic Surg 1979;10:87-92. 5. Driebe WT, Mandelbaum S, Forster RK, et al: Pseudophakic endophthalmitis: Diagnosis and management . Ophthalmology 1986;93:442-448.Crossref 6. Puliafito CA, Baker AS, Haaf J, et al: Infectious endophthalmitis . Ophthalmology 1982;89:921-929.Crossref 7. Forster RK, Abbott RL, Gelender H: Management of infectious endophthalmitis . Ophthalmology 1980;87:313-319.Crossref 8. Diamond JG: Intraocular management of endophthalmitis . Arch Ophthalmol 1981;99:96-99.Crossref 9. Rowsey JJ, Newsom DL, Sexton DJ, et al: Endophthalmitis: Current approaches . Ophthalmology 1982;89:1055-1066.Crossref 10. Nelsen PT, Marcus DA, Bovino JA: Retinal detachment following endophthalmitis . Ophthalmology 1985;92:1112-1117.Crossref 11. Brinton GS, Topping TM, Hyndiuk RA, et al: Posttraumatic endophthalmitis . Arch Ophthalmol 1984;102:547-550.Crossref 12. Olson JC, Flynn HW, Forster RK, et al: Results in the treatment of postoperative endophthalmitis . Ophthalmology 1983;90:692-699.Crossref 13. Bohigian GM, Olk RJ: Factors associated with a poor visual result in endophthalmitis . Am J Ophthalmol 1986;101:332-334. 14. Talamo JH, D'Amico DJ, Hanninen LA, et al: The influence of aphakia and vitrectomy on experimental retinal toxicity of aminoglycoside antibiotics . Am J Ophthalmol 1985;100:840-847. 15. Beyer TL, Vogler G, Sharma D, et al: Protective barrier effect of the posterior lens capsule in exogenous bacterial endophthalmitis: An experimental primate study . Invest Ophthalmol Vis Sci 1984;25:108-112. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

The Role of Vitrectomy in the Treatment of Postoperative Bacterial Endophthalmitis: An Experimental Study

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References (19)

Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1987.01060120097034
Publisher site
See Article on Publisher Site

Abstract

Abstract • While the diagnostic value of vitreous culture in the management of bacterial endophthalmitis is well established, the therapeutic value of vitrectomy in this condition is debated. The present experimental study uses an aphakic model of Staphylococcus aureus endophthalmitis in the rabbit. Animals were treated with the following: (1) intravitreal antibiotics alone; (2) intravitreal antibiotics with vitrectomy; (3) vitrectomy alone; and (4) no treatment. Eyes treated with antibiotics and vitrectomy displayed significantly clearer media at 14 days after therapy compared with eyes treated with antibiotics alone. There was also a greater tendency for eyes treated with antibiotics and vitrectomy to have negative cultures at 14 days, although this difference was not statistically significant. These findings are consistent with beneficial effects of therapeutic vitrectomy as an adjunct to intravitreal antibiotic therapy in an animal model of aphakic bacterial endophthalmitis. References 1. Forster RK, Zachary IG, Cottingham AJ, et al: Further observation on the diagnosis, cause, and treatment of endophthalmitis . Am J Ophthalmol 1976;81:52-56. 2. Peyman GA, Paque JT, Meisels HI, et al: Postoperative endophthalmitis: A comparison of methods for treatment and prophylaxis with gentamicin . Ophthalmic Surg 1975;6:45-55. 3. Cottingham AJ, Forster RK: Vitrectomy in endophthalmitis . Arch Ophthalmol 1976;94:2078-2081.Crossref 4. McGetrick JJ, Peyman GA: Vitrectomy in experimental endophthalmitis: II. Bacterial endophthalmitis . Ophthalmic Surg 1979;10:87-92. 5. Driebe WT, Mandelbaum S, Forster RK, et al: Pseudophakic endophthalmitis: Diagnosis and management . Ophthalmology 1986;93:442-448.Crossref 6. Puliafito CA, Baker AS, Haaf J, et al: Infectious endophthalmitis . Ophthalmology 1982;89:921-929.Crossref 7. Forster RK, Abbott RL, Gelender H: Management of infectious endophthalmitis . Ophthalmology 1980;87:313-319.Crossref 8. Diamond JG: Intraocular management of endophthalmitis . Arch Ophthalmol 1981;99:96-99.Crossref 9. Rowsey JJ, Newsom DL, Sexton DJ, et al: Endophthalmitis: Current approaches . Ophthalmology 1982;89:1055-1066.Crossref 10. Nelsen PT, Marcus DA, Bovino JA: Retinal detachment following endophthalmitis . Ophthalmology 1985;92:1112-1117.Crossref 11. Brinton GS, Topping TM, Hyndiuk RA, et al: Posttraumatic endophthalmitis . Arch Ophthalmol 1984;102:547-550.Crossref 12. Olson JC, Flynn HW, Forster RK, et al: Results in the treatment of postoperative endophthalmitis . Ophthalmology 1983;90:692-699.Crossref 13. Bohigian GM, Olk RJ: Factors associated with a poor visual result in endophthalmitis . Am J Ophthalmol 1986;101:332-334. 14. Talamo JH, D'Amico DJ, Hanninen LA, et al: The influence of aphakia and vitrectomy on experimental retinal toxicity of aminoglycoside antibiotics . Am J Ophthalmol 1985;100:840-847. 15. Beyer TL, Vogler G, Sharma D, et al: Protective barrier effect of the posterior lens capsule in exogenous bacterial endophthalmitis: An experimental primate study . Invest Ophthalmol Vis Sci 1984;25:108-112.

Journal

Archives of Ophthalmology – American Medical Association

Published: Dec 1, 1987

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