Intravitreal dexamethasone appears a useful adjunct for post-cataract endophthalmitis

This study published in the October issue of the British Journal of Ophthalmology evaluated intravitreal dexamethasone as adjunctive therapy for presumed bacterial endophthalmitis, and found that steroids may improve visual outcomes.

The double-masked study randomized 62 patients with presumed bacterial endophthalmitis to receive intravitreal ceftazidime (2.225 mg/0.1 ml) and vancomycin (1 mg/0.1 ml) plus dexamethasone (0.4 mg/0.1) or the two antibiotics plus placebo.

Vision improved by a mean 2.79 Snellen lines in the intravitreal group versus 1.8 lines in the placebo group, which was not significantly different. However, subgroup analysis found that visual acuity improved by a mean 4.1 lines in the 17 postcataract surgery patients who received intravitreal dexamethasone versus 2.7 lines in the 15 postcataract surgery patients given placebo (P = 0.33). No adverse events attributable to dexamethasone were reported.

The authors conclude that intravitreal dexamethasone appears safe and may be of benefit in patients with bacterial endophthalmitis following cataract surgery.