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Immediate Vitrectomy and Intravenous Antibiotics for the Treatment of Postoperative Bacterial Endophthalmitis

The Endophthalmitis Vitrectomy Study (EVS) was a randomized, controlled clinical trial to determine the roles of immediate pars plana vitrectomy and systemic antibiotic treatment in the management of postoperative endophthalmitis in patients with clinical signs and symptoms of bacterial endophthalmitis within 6 weeks of cataract surgery or secondary intraocular lens (IOL) implantation and visual acuity between 20/50 and light perception. The study found that routine immediate pars plana vitrectomy is not necessary in patients with better than light perception vision at presentation but is of substantial benefit for those who have light perception-only vision (or worse). Most patients do not require treatment with intravenous antibiotics. Omission of systemic antibiotic treatment can reduce toxic effects, costs, and length of hospital stay.