Treatment modalities in postoperative endophthalmitis

    Abstract

    Treatment modalities in postoperative endophthalmitis

    S. Kaynak, R. Aydin

    Dokuz Eylul University, Izmir (Turkey)
Edward Harkness Eye Institute, Columbia University, New York, Ny (USA)
Medipol University, Istanbul (Turkey)

    This article reviews the modern treatment modalities of postoperative endophthalmitis. Treatment algoritm of endophthalmitis is proposed: microbiologic diagnosis, intravitreal treatment with antibiotics, topical and systemic antibiotics, vitrectomy surgery.

    The prophylactic protocol of ECRS study shows that if we use quinolone drops before and after surgery and 5% povidone iodine drops just before starting surgery and intracamaral cefuroxime 1 mgr/ 0.1ml at the end of surgery gives us the least endophthalmitis rates ever, such as 0.02% culture positivity.

    The diagnosis of endophthalmitis sometimes controversial in early period but, signs and symptoms must evaluate very carefully and make the decision as soon as possible. Then start to management algoritm step by step with obtaining the vitreous samples, intravitreal antibiotic injections and very tight control to evaluate if the case has a regression and make sure the indication of vitrectomy surgery. In last years surgical indications could be used earlier than before because of the advanced technics and technology in PPV surgery. The results are quite successfulanatomically as high as 90% recently.

    Key words: postoperative endophthalmitis, microbiologic diagnosis, intravitreal treatment, prophylactic protocol.