Current knowledge on treatment of endophthalmitis.

Abstract

PURPOSE: To ascertain current knowledge on the treatment of endophthalmitis. METHODS: Using Pubmed as database, we selected articles written in English related to endophthalmitis and vitrectomy, antibiotic therapy and steroid therapy. RESULTS: Early vitrectomy should be considered in elected cases based on clinical criteria such as degree on inflammation, corneal opacification and course of disease, despite presenting visual acuity. Intravitreal antibiotic therapy with vancomycin and ceftazidime remains the therapy of choice. Systemic therapy with 3rd or 4th generation fluoroquinolones can be used as an adjunct to reduce the need of reintervention. Single therapy with systemic antibiotics should not be considered. Prophylactic measures with intracameral moxifloxacin or cefuroxime have shown to be effective in reducing the risk of post-cataract surgery endophthalmitis. Steroid therapy remains a controversial topic and should be used with discretion, according to the clinician's insight. CONCLUSION: Other clinical criteria should be considered in selecting cases for vitrectomy, instead of visual acuity alone. Systemic therapy with latest generations fluoroquinolone may be useful as an adjunct to intravitreal antibiotics. Steroid therapy is controversial and should be carefully considered.