Intravitreal Povidone-Iodine Injection and Low-Dose Antibiotic Irrigation for Infectious Endophthalmitis: A...

Area of Science:

• Ophthalmology
• Infectious Diseases
• Surgical Complications

Background:

• Infectious endophthalmitis is a severe complication of intraocular procedures.
• Current treatments face challenges with antibiotic resistance and toxicity (e.g., vancomycin-associated hemorrhagic occlusive retinal vasculitis).
• Alternative antimicrobial strategies are urgently needed.

Purpose of the Study:

• To assess the clinical efficacy and safety of a combined protocol for infectious endophthalmitis.
• The protocol involves intravitreal povidone-iodine (PI) injection and intraoperative irrigation with vancomycin and ceftazidime.

Main Methods:

• Retrospective analysis of 11 eyes with endophthalmitis.
• Treatment included initial intravitreal PI, pars plana vitrectomy with vancomycin/ceftazidime irrigation, and repeat PI injections.
• Outcomes measured: best-corrected visual acuity (BCVA), microbial cultures, corneal endothelial cell density, visual fields.

Main Results:

• Complete infection resolution achieved in all cases without recurrence.
• Significant improvement in mean BCVA from 2.18 to 0.296 logMAR (p < 0.001).
• No adverse events noted on specular microscopy or visual field testing; protocol well-tolerated.

Conclusions:

• The combination protocol is a safe and effective treatment for infectious endophthalmitis.
• It allows for rapid and complete infection resolution with reduced risks compared to standard intravitreal antibiotics.
• This approach presents a practical, globally accessible alternative for endophthalmitis management.