William F Mieler MD

Synopsis:

Endophthalmitis remains one of the most feared complications of intraocular surgery. Thispresentation will review the incidence of infection following pars plana vitrectomy,intravitreal injections, and cataract procedures. Some historical details will be discussed,including the recommendations from the Endophthalmitis Vitrectomy Study (EVS), andwhether or not these 25 year old results are still valid and applicable today. Then attentionwill focus on new developments in the treatment of proven infection, and an update as tocurrent means of therapy will be discussed. A signi?cant number of the improvements havebeen in the realm of new and more effective antimicrobial therapy, not only in the setting ofbacterial infection, though also in trauma-related cases, as well as in indolent and fungalinfections. Also to be discussed will be the role of corticosteroids in the management ofinfection, and also the potential (negative) impact of systemic diseases on the response totreatment.Then, the presentation will cover prophylaxis against the development of infection, includingnew forthcoming recommendations in the setting of intravitreal injections. Finally, theongoing debate regarding intracameral antibiotic prophylaxis in the setting of cataractsurgery will be reviewed as well.