Vitrectomie et endophtalmie

The decision to perform a vitrectomy in a case of endophthalmitis is mainly based on the Endophthalmitis Vitrectomy Study (EVS) conclusions. An emergency vitrectomy is helpful when the baseline visual acuity is lower than hand motion perceptions. However, various coexisting conditions should be considered: clear media and the availability of an operating room dedicated to emergency surgery. These limitations lead to a frequent delay in vitrectomy to assess the progression of the initial presentation after treatment with antibiotics and anti-inflammatory agents. However, in these cases, the vitrectomy will remain restricted to the center of the vitreous cavity to limit peripheral retinovitreal traction favoring retinal detachment. Vitrectomy performed to treat the residual vitreous opacity or macular complications such as epiretinal membranes, subject to even greater delay, is another indication.