There have been numerous advances in both the diagnosis and management
of infectious endophthalmitis. The recently published results of the
Endophthalmitis Vitrectomy Study further added to our understanding of
the microbiological features, clinical course, and management of post
operative infectious endophthalmitis. The Endophthalmitis Vitrectomy S
tudy confirmed that the Gram-positive coagulase-negative organisms are
the most common cause of acute endophthalmitis after cataract or seco
ndary intraocular lens surgery, The Endophthalmitis Vitrectomy Study a
lso confirmed the efficacy of treatment with intravitreal vancomycin a
nd amikacin. In this study, an immediate pars plana vitrectomy yielded
better visual acuity outcomes when compared with a vitreous aspiratio
n or biopsy in eyes with light-perception-only vision. The study did n
ot demonstrate a difference between groups (vitrectomy versus tap/biop
sy) in eyes with better than light-perception-only visual acuity. Fina
lly, the study demonstrated that in the Endophthalmitis Vitrectomy Stu
dy systemic antibiotics (amikacin and ceftazidime) were not of benefit
judged by the outcome of final Visual acuity and media clarity. Newer
, less toxic, antifungal agents with good intraocular penetration are
available to supplement the treatment of endogenous fungal endophthalm
itis.