Adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery

Edward F Hall1, Garrett R Scott1, David C Musch1,2, David N Zacks11Department of Ophthalmology and Visual Sciences, Medical School; 2Department of Epidemiology, School of Public Health; University of Michigan, Ann Arbor, MI, USAPurpose: Controversy exists regarding the use of intravitreal dexamethas...

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Autores principales:	Edward F Hall, Garrett R Scott, David C Musch, David N Zacks
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/5e40aae31fec452bb74033ef9c8cbee6
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spelling	oai:doaj.org-article:5e40aae31fec452bb74033ef9c8cbee62021-12-02T04:56:59ZAdjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery1177-54671177-5483https://doaj.org/article/5e40aae31fec452bb74033ef9c8cbee62008-03-01T00:00:00Zhttp://www.dovepress.com/adjunctive-intravitreal-dexamethasone-in-the-treatment-of-acute-endoph-a350https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Edward F Hall1, Garrett R Scott1, David C Musch1,2, David N Zacks11Department of Ophthalmology and Visual Sciences, Medical School; 2Department of Epidemiology, School of Public Health; University of Michigan, Ann Arbor, MI, USAPurpose: Controversy exists regarding the use of intravitreal dexamethasone (IVD) as an anti-inflammatory adjunct to intravitreal antibiotics in patients with acute endophthalmitis following cataract surgery. The purpose of this project was to evaluate our experience regarding the effect of adjunctive IVD use on visual outcomes in such patients.Design: Retrospective, comparative case series.Methods: Study population: Patients treated for acute endophthalmitis following cataract surgery from 1995&ndash;2004. Intervention: In addition to standard intravitreal antibiotic treatment, some patients also received a single adjunctive injection of IVD. Primary outcome measures: Median visual acuity at last follow-up and percentage of patients achieving a &ge;3-line improvement in visual acuity. Secondary outcome measures: Inflammatory index scoring, including amount of cell and flare, height of hypopyon, and presence of fibrin as a function of time after treatment.Results: Twenty-six eyes were treated with and 38 eyes without adjunctive IVD. Median presenting visual acuity was Hand Motion in both groups. Median visual acuity at last followup measured 20/40 in the IVD group and 20/50 in the No-IVD group (p = 0.75). Seventy-three percent of patients in the IVD group and 82% of patients in the No-IVD group achieved a &ge;3-line improvement in visual acuity (p = 0.42). No significant difference was detected between the IVD and No-IVD groups for any of the three measures of inflammation.Conclusion: The use of IVD did not significantly improve the final median visual acuity, the chance of achieving a &ge;3-line improvement in visual acuity, or the amount of intraocular inflammation. Based on these findings, and the possible detrimental effect of IVD on visual outcomes previously reported in the literature, the use of IVD does not appear to be warranted as a routine adjunctive treatment in postoperative endophthalmitis.Keywords: endophthalmitis, dexamethasone, intravitreal injection Edward F HallGarrett R ScottDavid C MuschDavid N ZacksDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2008, Iss Issue 1, Pp 139-145 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Edward F Hall Garrett R Scott David C Musch David N Zacks Adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery
description	Edward F Hall1, Garrett R Scott1, David C Musch1,2, David N Zacks11Department of Ophthalmology and Visual Sciences, Medical School; 2Department of Epidemiology, School of Public Health; University of Michigan, Ann Arbor, MI, USAPurpose: Controversy exists regarding the use of intravitreal dexamethasone (IVD) as an anti-inflammatory adjunct to intravitreal antibiotics in patients with acute endophthalmitis following cataract surgery. The purpose of this project was to evaluate our experience regarding the effect of adjunctive IVD use on visual outcomes in such patients.Design: Retrospective, comparative case series.Methods: Study population: Patients treated for acute endophthalmitis following cataract surgery from 1995&ndash;2004. Intervention: In addition to standard intravitreal antibiotic treatment, some patients also received a single adjunctive injection of IVD. Primary outcome measures: Median visual acuity at last follow-up and percentage of patients achieving a &ge;3-line improvement in visual acuity. Secondary outcome measures: Inflammatory index scoring, including amount of cell and flare, height of hypopyon, and presence of fibrin as a function of time after treatment.Results: Twenty-six eyes were treated with and 38 eyes without adjunctive IVD. Median presenting visual acuity was Hand Motion in both groups. Median visual acuity at last followup measured 20/40 in the IVD group and 20/50 in the No-IVD group (p = 0.75). Seventy-three percent of patients in the IVD group and 82% of patients in the No-IVD group achieved a &ge;3-line improvement in visual acuity (p = 0.42). No significant difference was detected between the IVD and No-IVD groups for any of the three measures of inflammation.Conclusion: The use of IVD did not significantly improve the final median visual acuity, the chance of achieving a &ge;3-line improvement in visual acuity, or the amount of intraocular inflammation. Based on these findings, and the possible detrimental effect of IVD on visual outcomes previously reported in the literature, the use of IVD does not appear to be warranted as a routine adjunctive treatment in postoperative endophthalmitis.Keywords: endophthalmitis, dexamethasone, intravitreal injection
format	article
author	Edward F Hall Garrett R Scott David C Musch David N Zacks
author_facet	Edward F Hall Garrett R Scott David C Musch David N Zacks
author_sort	Edward F Hall
title	Adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery
title_short	Adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery
title_full	Adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery
title_fullStr	Adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery
title_full_unstemmed	Adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery
title_sort	adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/5e40aae31fec452bb74033ef9c8cbee6
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Adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery

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