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Vitrectomy in Endophthalmitis: Results of Study Using Vitrectomy, Intraocular Antibiotics, or a Combination of Both

Vitrectomy in Endophthalmitis: Results of Study Using Vitrectomy, Intraocular Antibiotics, or a... Abstract • A rabbit model of endophthalmitis was produced by inoculating Staphylococcus epidermidis and S aureus into the vitreous cavity. Elimination of microorganisms was compared using intravitreal administration of 0.1 mg of gentamicin alone, vitrectomy alone, and a combination of gentamicin and vitrectomy. In the case of S epidermidis treated 24 hours after inoculation, all untreated eyes were culture-positive at one week, eyes treated with gentamicin alone or intravitreal gentamicin in combination with vitrectomy were all culture-negative, and vitrectomy alone rendered half of the eyes culture-negative. In the case of S aureus, eyes not treated by vitrectomy alone were all culture-positive at one week. Eyes treated with intravitreal gentamicin 25 to 31 hours after infection were culture-negative for S aureus in 33% at one week, while eyes treated with combined vitrectomy plus intraocular gentamicin were culture-negative in 83% of cases. When treatment was delayed 40 to 49 hours after inoculation of S aureus, intravitreal gentamicin rendered 50% culture-negative at one week, while vitrectomy combined with intravitreal gentamicin eliminated the infection in 100% of eyes. References 1. Peyman GA, Vastine DW, Crouch ER, et al: Clinical use of intravitreal antibiotics to treat bacterial endophthalmitis . Trans Am Acad Ophthalmol Otolaryngol 78:862-875, 1974. 2. Forster RK, Zachary IG, Cottingham AJ, et al: Further observations on the diagnosis, etiology and treatment of endophthalmitis . Am J Ophthalmol 81:52-56, 1976. 3. Peyman GA, May DR, Ericson ES, et al: Intraocular injection of gentamicin: Toxic effects and clearance . Arch Ophthalmol 92:42-47, 1974.Crossref 4. Zachary IG, Forster RK: Experimental intravitreal gentamicin. Am J Ophthalmol, to be published. 5. Maylath FR, Leopold IH: Study of experimental intraocular infection: I. The recoverability of organisms inoculated into ocular tissues and fluids: II. The influence of antibiotics and cortisone alone and combined, on intraocular growth of these organisms . Am J Ophthalmol 40:86-101, 1955. 6. Machemer R: A new concept for vitreous surgery: II. Surgical technique and complications . Am J Ophthalmol 74:1022-1033, 1972. 7. Machemer R: A new concept for vitreous surgery: VII. Two instrument techniques in pars plana vitrectomy . Arch Ophthalmol 92:407-412, 1974.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Vitrectomy in Endophthalmitis: Results of Study Using Vitrectomy, Intraocular Antibiotics, or a Combination of Both

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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1976.03910040738007
Publisher site
See Article on Publisher Site

Abstract

Abstract • A rabbit model of endophthalmitis was produced by inoculating Staphylococcus epidermidis and S aureus into the vitreous cavity. Elimination of microorganisms was compared using intravitreal administration of 0.1 mg of gentamicin alone, vitrectomy alone, and a combination of gentamicin and vitrectomy. In the case of S epidermidis treated 24 hours after inoculation, all untreated eyes were culture-positive at one week, eyes treated with gentamicin alone or intravitreal gentamicin in combination with vitrectomy were all culture-negative, and vitrectomy alone rendered half of the eyes culture-negative. In the case of S aureus, eyes not treated by vitrectomy alone were all culture-positive at one week. Eyes treated with intravitreal gentamicin 25 to 31 hours after infection were culture-negative for S aureus in 33% at one week, while eyes treated with combined vitrectomy plus intraocular gentamicin were culture-negative in 83% of cases. When treatment was delayed 40 to 49 hours after inoculation of S aureus, intravitreal gentamicin rendered 50% culture-negative at one week, while vitrectomy combined with intravitreal gentamicin eliminated the infection in 100% of eyes. References 1. Peyman GA, Vastine DW, Crouch ER, et al: Clinical use of intravitreal antibiotics to treat bacterial endophthalmitis . Trans Am Acad Ophthalmol Otolaryngol 78:862-875, 1974. 2. Forster RK, Zachary IG, Cottingham AJ, et al: Further observations on the diagnosis, etiology and treatment of endophthalmitis . Am J Ophthalmol 81:52-56, 1976. 3. Peyman GA, May DR, Ericson ES, et al: Intraocular injection of gentamicin: Toxic effects and clearance . Arch Ophthalmol 92:42-47, 1974.Crossref 4. Zachary IG, Forster RK: Experimental intravitreal gentamicin. Am J Ophthalmol, to be published. 5. Maylath FR, Leopold IH: Study of experimental intraocular infection: I. The recoverability of organisms inoculated into ocular tissues and fluids: II. The influence of antibiotics and cortisone alone and combined, on intraocular growth of these organisms . Am J Ophthalmol 40:86-101, 1955. 6. Machemer R: A new concept for vitreous surgery: II. Surgical technique and complications . Am J Ophthalmol 74:1022-1033, 1972. 7. Machemer R: A new concept for vitreous surgery: VII. Two instrument techniques in pars plana vitrectomy . Arch Ophthalmol 92:407-412, 1974.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Dec 1, 1976

References