TREATMENT OF EXPERIMENTAL METHICILLIN-RESISTANT STAPHYLOCOCCUS-EPIDERMIDIS ENDOPHTHALMITIS WITH INTRAVITREAL VANCOMYCIN AND INTRAVITREAL DEXAMETHASONE

The use of intravitreal steroids to treat bacterial endophthalmitis re mains controversial, The efficacy of intravitreal vancomycin alone (gr oup 1), intravitreal dexamethasone alone (group 2), and a combination of intravitreal vancomycin and dexamethasone (group 3) in the treatmen t of experimental methicillin-resistant Staphylococcus epidermidis end ophthalmitis was evaluated in a rabbit model: 24 h after bacterial ino culation of all eyes, right eyes were treated and left eyes served as infected controls. Vitreal aspirations and grading of vitreal inflamma tory reaction were done regularly until sacrifice. Group 2 eyes demons trated more inflammation histologically than control eyes, Vitreal asp irations demonstrated no growth by 5 days from groups 1 and 3 eyes. Al though the clinical appearance was not significantly different between groups 1 and 3, the histologic appearance of group 3 eyes showed less intense intraocular inflammation. Treatment with dexamethasone in the absence of appropriate antibiotics was more harmful than no treatment at all (P < .05), Therapy with both intravitreal vancomycin and dexam ethasone results in less inflammation than intravitreal vancomycin alo ne in this model.