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Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 12/2005

01.12.2005 | Clinical Investigation

Intravitreal dexamethasone as adjuvant in the treatment of postoperative endophthalmitis: a prospective randomized trial

verfasst von: Ivan M. Gan, Luana C. Ugahary, Jaap T. van Dissel, Eric Feron, Ed Peperkamp, Marc Veckeneer, Paul G. H. Mulder, Gert Jan Platenkamp, Jan C. van Meurs

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 12/2005

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Abstract

Purpose

To study whether intravitreal dexamethasone as adjuvant to intravitreal antibiotics improves the outcome in patients with suspected postoperative bacterial endophthalmitis.

Design

Prospective randomized clinical trial.

Setting

Tertiary referral center.

Patient population

Twenty-nine consecutive patients with suspected postoperative bacterial endophthalmitis within 6 weeks of cataract surgery.

Intervention

Patients underwent a vitreous biopsy followed by intravitreal injection of antibiotics (0.2 mg vancomycin and 0.05 mg gentamicin) and 400 μg dexamethasone or placebo. After 3–4 days the intravitreal injection of antibiotics and dexamethasone or placebo was repeated

Primary outcome measure

Snellen visual acuity at 3 and 12 months after treatment.

Results

In 20/29 patients (69%) the vitreous cultures were positive. 13/29 patients received dexamethasone. Seven patients had a functionally lost eye (final vision of hand movements or less), in four due to retinal detachment. Visual acuity tended to be better in the dexamethasone treated patients than in those given placebo, at both 3 months (P=0.055) and 12 months (P=0.080).

Conclusion

This small prospective, placebo-controlled series showed a trend towards a better visual outcome in patients with suspected bacterial endophthalmitis when treatment with intravitreal antibiotics was combined with intravitreal dexamethasone. Our findings justify a larger multicenter randomized study.
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Metadaten
Titel
Intravitreal dexamethasone as adjuvant in the treatment of postoperative endophthalmitis: a prospective randomized trial
verfasst von
Ivan M. Gan
Luana C. Ugahary
Jaap T. van Dissel
Eric Feron
Ed Peperkamp
Marc Veckeneer
Paul G. H. Mulder
Gert Jan Platenkamp
Jan C. van Meurs
Publikationsdatum
01.12.2005
Verlag
Springer-Verlag
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 12/2005
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-005-0133-1

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