Visual outcomes following the use of intravitreal steroids in the treatment of postoperative endophthalmitis.
OBJECTIVE
To compare visual outcomes between cases of acute postoperative endophthalmitis that did or did not receive intravitreal steroids.


METHODS
Retrospective nonrandomized comparative trial.


METHODS
Fifty-seven patients with postoperative endophthalmitis.


METHODS
Thirty-one patients with postoperative endophthalmitis resulting from cataract extraction received both intravitreal antibiotics and steroids, whereas the remaining 26 received only intravitreal antibiotics.


METHODS
Improvement in visual acuity.


RESULTS
Multivariate logistic regression was used to analyze the variables that potentially influence a three-line visual acuity improvement. The mean baseline visual acuities of both groups were comparable. The use of intravitreal steroids reduced the probability of developing a three-line improvement in visual acuity (odds ratio [OR] = 0.287; 95% confidence interval [CI] [0.072-0.852]). On the basis of logistic regression analysis using our multivariate model, gender, baseline visual acuity, and pars plana vitrectomy were not significantly associated with visual outcome differences between the two groups.


CONCLUSIONS
Patients who received intravitreal steroids had a significantly reduced likelihood of obtaining a three-line improvement in visual acuity. At a minimum our study provides no support for their use and, therefore, steroids may not be efficacious for acute endophthalmitis related to cataract extraction.
Shah
G K
GK
Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
Stein
J D
JD
Sharma
S
S
Sivalingam
A
A
Benson
W E
WE
Regillo
C D
CD
Brown
G C
GC
Tasman
W
W
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000583:Amikacin / Q000627:therapeutic use; D002387:Cataract Extraction / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014640:Vancomycin / Q000627:therapeutic use; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000187:drug effects
D005938:Glucocorticoids; D014640:Vancomycin; D003907:Dexamethasone; D000583:Amikacin