Endophthalmitis not more common after PPV without use of topical antibiotics


Khundkar TZ, et al. Endophthalmitis after PPV without postoperative topical antibiotics. Presented at the American Society of Retina Specialists Annual Meeting; July 13-16, 2022; New York.

Disclosures: Khundkar does not report any relevant financial information.

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NEW YORK – A low rate of endophthalmitis after pars plana vitrectomy can be achieved without the use of postoperative topical antibiotics, according to a study presented here.

“Postoperative topical antibiotics are recommended by the Microsurgical Safety Task Force (2010) among others. However, they have recently shown that they reach effective levels in the aqueous humor but not in the vitreous humor,” Tahsin Z. Khundkar, MD, said at the annual meeting of the American Society of Retina Specialists.

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Tahsin Z. Khundkar

In addition, Abdhish R. Bhavsar presented at the 2020 Association for Vision and Ophthalmology Research meeting his 22-year experience as the sole surgeon in 4,868 vitrectomy surgeries without postoperative topical antibiotics, in which no cases of endophthalmitis have been reported.

Khundkar and colleagues conducted a retrospective analysis of 7,957 pars plana vitrectomy (PPV) procedures performed by multiple surgeons at a single facility between 2013 and 2021. Lens and trauma cases, as well as cases in which the vitrectomy was used to treat endophthalmitis, were excluded.

“All patients received povidone iodine scrub of the periorbital area as well as conjunctival irrigation with povidone iodine before surgery, and all cases were concluded with the injection of subconjunctival antibiotics and steroids No antibiotics were added to the infusion fluid and no topical antibiotic medications were given in the days following surgery,” Khundkar said.

A single case of postoperative endophthalmitis has been reported, representing an incidence rate of 0.13 per 1000 cases, in line with the reported incidence of 0.1 to 1.4 per 1000 cases in the literature.

“Performing PPV with standard preoperative preparation and subconjunctival injection of antibiotics without the use of postoperative topical antibiotics does not result in an increased incidence of postoperative endophthalmitis,” Khundkar said. .


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