The role of vitrectomy in the treatment of postoperative bacterial endophthalmitis. An experimental study

A. R. Talley, D. J. D'Amico, J. H. Talamo, V. N. Casey and K. R. Kenyon
Howe Laboratory of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston 02114.

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.