Aim: To determine the role of early vitrectomy versus intravitreal antibiotic injection in patients with postoperative endophthalmitis. Design: Randomized, prospective study. Material and methods: A total of 20 patients who had clinical evidence of endophthalmitis within 6 weeks after cataract surgery were included in the study. Patients
were randomized into two groups. In Group A (n = 7) patients underwent core vitrectomy along with intravitreal antibiotics injection within 48 hours of presentation while in Group B (n = 13) patients received intavitreal antibiotic injection only. Results: In Group A (n = 7), all the patients had improvement in visual acuity. Out of total 7 patients,
5 (71.42%) patients achieved visual acuity of 6/60 or better, while in Group B (n = 13), 5 (38.46%) patients had improvement in visual acuity, 3 (30.76%) patients did not show any improvement or worsening and 5 (38.46%) patients had worsening of initial visual acuity. The media clarity improved significantly in all the patients of Group A (n = 7), in which 6 (85.71%) patients achieved the media clarity of Grade 1, while in Group B (n = 13) 6 (46.15%) patients achieved media clarity of Grade 1 and 2 (15.38%) patients did not have any improvement in media clarity during the follow-up period of 3 months. The complications were more in Group B as 2 (15.38%) patients developed retinal detachment, 1 (7.69%) patient had phthisis and 1(7.69%) patient worsened to panophthalmitis while in Group A only 1 (14.28%) patient developed retinal detachment 2 months after the vitrectomy. Conclusion: Early
vitrectomy when done within 48 hours greatly improves visual acuity and media clarity when compared with intravitreal antibiotics injection alone.
Keywords: Postoperative endophthalmitis; Early vitrectomy and intravitreal antibiotics.