No need for dexamethasone for endophthalmitis treatment

February 11, 2008

The use of intravitreal dexamethasone (IVD) is not warranted as a routine adjunctive treatment in postoperative endophthalmitis.

The use of intravitreal dexamethasone (IVD) is not warranted as a routine adjunctive treatment in postoperative endophthalmitis, according to a study published online ahead of print by Clinical Ophthalmology.

Edward Hall and colleagues from the University of Michigan, USA conducted a retrospective, comparative case series to evaluate the effect of adjunctive IVD use on visual outcomes in patients with acute endophthalmitis following cataract surgery. The study included 26 patients treated with adjunctive IVD and 38 without, between 1995 and 2004.

Median presenting visual acuity (VA) was hand motion in both groups. Median VA at last follow-up was 20/40 in the IVD group and 20/50 in the non-IVD group (p=0.75). Seventy-three percent of patients in the IVD groups and 82% in the non-IVD group achieved a ≥3 line improvement in VA (p=0.42). No significant difference was recorded between the two groups in cell count and flare, height of hypopyon or presence of fibrin as a function of time after treatment.

The use of IVD does not significantly improve final median VA or the amount of intraocular inflammation and thus, according to the authors, is not warranted as a routine adjunctive treatment in postoperative endophthalmitis.