Current Strategies for Prevention and Treatment of Postoperative Endophthalmitis

• Published in: Current ophthalmology reports Vol. 6; no. 2; pp. 105 - 114
• Main Authors: Brundrett, Ashley, Conrady, Christopher D., Shakoor, Akbar, Lin, Amy
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2018; Springer Nature B.V
• Subjects: Antibiotics; Cataracts; Cohort analysis; Disease prevention; Drug resistance; Eye surgery; Iodine; Medicine; Medicine & Public Health; Observational studies; Ocular Microbiology and Immunology (B Jeng and L Schocket; Ophthalmology; Section Editors; Standard of care; Topical Collection on Ocular Microbiology and Immunology; United States > US; Intracameral antibiotics; Endophthalmitis; Postoperative endophthalmitis
• ISSN: 2167-4868; 2167-4868
• DOI: 10.1007/s40135-018-0171-6

Purpose of review We review the prevention and treatment of postoperative endophthalmitis. Recent findings Postoperative endophthalmitis is rare but has potentially blinding consequences. There is no consensus on prevention, but there are a few controlled studies with methods of decreasing the infection rate, such as use of povidone iodine and intracameral antibiotics. There remains only one randomized controlled study (Endophthalmitis Vitrectomy Study or EVS) on the treatment of postoperative endophthalmitis, but there are retrospective studies which examine the timing and various methods of vitrectomy and intravitreal antibiotics. Summary The application of povidone iodine remains a proven method of preventing endophthalmitis, but evidence suggests that intracameral antibiotics further minimize this risk. Further research is needed to define the efficacy of intravitreal antibiotics at the time of cataract surgery. There are many questions regarding treatment, including performance of vitrectomy for eyes with visual acuities better than light perception, smaller vitrectomy port sizes, and intravitreal antibiotics and/or oral steroids.