The Endophthalmitis Vitrectomy Study

Abstract

The managementof endophthalmitis has gained increasing interest during the past two decades, particularly as a complication of cataract surgery, glaucoma filtering surgery, and penetrating ocular trauma. The use of intraocular antibiotics by intravitreal injection has now been widely accepted, with some questions as to the selection of the particular antibiotics. On the other hand, the role of therapeutic pars plana vitrectomy in the initial management of endophthalmitis and the benefit of systemic antibiotic therapy remain controversial. In this issue, the Endophthalmitis Vitrectomy Study (EVS) Group reports the results of a randomized trial of immediate pars plana vitrectomy and systemic antibiotics for the treatment of postoperative bacterial endophthalmitis.¹ Despite being controversial, an increasing proportion of patients with endophthalmitis undergo therapeutic vitrectomy as part of the initial management.²Experimental studies were prompted by the theoretical advantages offered by the technique of vitrectomy, including the removal and reduction of infecting