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Intravitreal antibiotic therapy with vancomycin and aminoglycoside: examination of the retinal toxicity of repetitive injections after vitreous and lens surgery

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Abstract

The combination of vancomycin and an aminoglycoside antibiotic is frequently injected into aphakic/vitrectomized eyes for the treatment of endophthalmitis. At 2 weeks after lens and vitreous removal, rabbit eyes received an injection of a combination of 1 mg vancomycin and either 400 μg amikacin or 100 μg gentamicin. Furthermore, the effects of repeating the same combination a second and third time at intervals of 48 h were examined by light and transmission electron microscopy at 7 days to 4 months after the last injection. A single injection of either combination produced no toxicity. After 2 or 3 sets of injections of either combination, 13 of 16 eyes displayed retinal toxicity manifested by macrophages in the subretinal space, disorganization of the outer segments and retinal pigment epithelium, and discontinuities in Bruch's membrane. These results indicate that whereas a single injection of these combinations is not toxic to aphakic/vitrectomized eyes, repetitive injections may result in increasing toxicity.

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Author notes

  1. Donald J. D'Amico

    Present address: Retina Service, Massachusetts Eye and Ear Infirmary, 243 Charles Street, 01224, Boston, MA, USA

Authors and Affiliations

  1. Department of Ophthalmology, Harvard Medical School, Retina Service and the Howe Laboratory of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Mass, USA

    Boo Sup Oum, Donald J. D'Amico, Hyung Woo Kwak & Kai W. Wong

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  1. Boo Sup Oum
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  2. Donald J. D'Amico
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  3. Hyung Woo Kwak
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  4. Kai W. Wong
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Oum, B.S., D'Amico, D.J., Kwak, H.W. et al. Intravitreal antibiotic therapy with vancomycin and aminoglycoside: examination of the retinal toxicity of repetitive injections after vitreous and lens surgery. Graefe's Arch Clin Exp Ophthalmol 230, 56–61 (1992). https://doi.org/10.1007/BF00166763

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  • DOI: https://doi.org/10.1007/BF00166763

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