Intravitreal dexamethasone as adjuvant in the treatment of postoperative endophthalmitis: a prospective randomized trial
- Ivan M. GanAffiliated withThe Rotterdam Eye Hospital
- , Luana C. UgaharyAffiliated withThe Rotterdam Eye Hospital
- , Jaap T. van DisselAffiliated withDepartment of Infectious Diseases, University of Leiden Medical Center
- , Eric FeronAffiliated withThe Rotterdam Eye Hospital
- , Ed PeperkampAffiliated withThe Rotterdam Eye Hospital
- , Marc VeckeneerAffiliated withThe Rotterdam Eye Hospital
- , Paul G. H. MulderAffiliated withDepartment of Epidemiology & Biostatistics, Erasmus University Medical Center Rotterdam
- , Gert Jan PlatenkampAffiliated withRegional Medical Microbiological Laboratory
- , Jan C. van MeursAffiliated withThe Rotterdam Eye Hospital Email author
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To study whether intravitreal dexamethasone as adjuvant to intravitreal antibiotics improves the outcome in patients with suspected postoperative bacterial endophthalmitis.
Prospective randomized clinical trial.
Tertiary referral center.
Twenty-nine consecutive patients with suspected postoperative bacterial endophthalmitis within 6 weeks of cataract surgery.
Patients underwent a vitreous biopsy followed by intravitreal injection of antibiotics (0.2 mg vancomycin and 0.05 mg gentamicin) and 400 μg dexamethasone or placebo. After 3–4 days the intravitreal injection of antibiotics and dexamethasone or placebo was repeated
Primary outcome measure
Snellen visual acuity at 3 and 12 months after treatment.
In 20/29 patients (69%) the vitreous cultures were positive. 13/29 patients received dexamethasone. Seven patients had a functionally lost eye (final vision of hand movements or less), in four due to retinal detachment. Visual acuity tended to be better in the dexamethasone treated patients than in those given placebo, at both 3 months (P=0.055) and 12 months (P=0.080).
This small prospective, placebo-controlled series showed a trend towards a better visual outcome in patients with suspected bacterial endophthalmitis when treatment with intravitreal antibiotics was combined with intravitreal dexamethasone. Our findings justify a larger multicenter randomized study.
KeywordsEndophthalmitis Dexamethasone Adjuvant
- Intravitreal dexamethasone as adjuvant in the treatment of postoperative endophthalmitis: a prospective randomized trial
Graefe's Archive for Clinical and Experimental Ophthalmology
Volume 243, Issue 12 , pp 1200-1205
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- 1. The Rotterdam Eye Hospital, PO Box 70030, 3000 LM, Rotterdam, The Netherlands
- 2. Department of Infectious Diseases, University of Leiden Medical Center, Leiden, The Netherlands
- 3. Department of Epidemiology & Biostatistics, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- 4. Regional Medical Microbiological Laboratory, Rotterdam, The Netherlands