The Efficacy of Intravitreal Vancomycin, Amikacin and Subtenon Triamcinolone in Bacterial Endophthalmitis Post Cataract Surgery-2

Abstract

Background Aim: To evaluate the use of the protocol of intravitreal  vancomycin, amikacin and subtenon triamcinolone  in the management  of presumed bacterial endophthalmitis.

Methods: 16 patients of bacterial endophthalmitis post cataract surgery were  received intravitreal amikacin (0.4 mg/0.1ml), vancomycin (1mg/0.1ml) Injections were repeated after 72h with the addition of subtenon 40mg triamcinolone in the second dose. The intravitreal antibiotic were repeated after 72h if it was necessary.

Results: The patients were evaluated by measuring visual acuity ,echo B ,clearance of the vitreous , within the first 14 days post injection, and at 2^e,4^e months and every 6 months. All the 16 patients completed the protocol from 2010 to 2020, there was a significant amelioration in all of our patients in the final visual acuity and clearance of the vitreous, no one of them had need a vitrectomy as a surgery for non-resolved endophthalmitis except one had operated for removing fibrous tissue enveloping the implanted lens.

Conclusions: the protocol of intravitreal injection of vancomycin, amikacin and subtenon triamcinolone appears of benefit in post cataract surgery bacterial endophthalmitis.

Moreover, studies with larger sample sizes are required to further evaluation the efficacy of  this protocol and reach a firmer conclusion.