Endophthalmitis not more frequent after PPV without use of topical antibiotics
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NEW YORK — A low rate of endophthalmitis following pars plana vitrectomy can be achieved without the use of postoperative topical antibiotics, according to a study presented here.
“Topical postoperative antibiotics are recommended by the Microsurgical Safety Task Force (2010) among others. However, they have recently shown to reach effective levels in the aqueous but not in the vitreous humor,” Tahsin Z. Khundkar, MD, said at the American Society of Retina Specialists annual meeting.
In addition, Abdhish R. Bhavsar presented at the 2020 Association for Research in Vision and Ophthalmology meeting his 22-year single-surgeon experience in 4,868 vitrectomy surgeries without postoperative topical antibiotics, in which no case of endophthalmitis was reported.
Khundkar and colleagues conducted a retrospective analysis of 7,957 pars plana vitrectomy (PPV) procedures performed by multiple surgeons at a single institution between 2013 and 2021. Lens and trauma cases, as well as cases in which vitrectomy was used to treat endophthalmitis, were excluded.
“All patients received a povidone-iodine scrub of the periorbital area along with povidone-iodine conjunctival irrigation prior to surgery, and all cases were concluded with injection of subconjunctival antibiotics and steroids. No antibiotics were added to the infusion fluid, and no topical antibiotic medications were given in the days after surgery,” Khundkar said.
Only one case of postoperative endophthalmitis was reported, accounting for an incidence rate of 0.13 per 1,000 cases, in line with the reported incidence of 0.1 to 1.4 per 1,000 cases in the literature.
“Performing PPV with standard preoperative preparation and subconjunctival injection of antibiotics without the use of postoperative topical antibiotics does not lead to an increase in incidence of postoperative endophthalmitis,” Khundkar said.
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Khundkar TZ, et al. Endophthalmitis after PPV without post-operative topical antibiotics. Presented at: American Society of Retina Specialists annual meeting; July 13-16, 2022; New York.
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