Early Vitrectomy Within Three Days of Symptom Onset is Associated with Greater Visual Recovery in Exogenous Infectious Endophthalmitis: A Retrospective Cohort Study

<p>To evaluate whether pars plana vitrectomy (PPV) performed within 72 hours of symptom onset is associated with greater visual recovery compared with initial tap-and-inject therapy in exogenous infectious endophthalmitis.</p> <p>Retrospective cohort study of consecutive patients with exogenous infectious endophthalmitis at a tertiary referral centre (2009–2018). Eyes were classified according to whether PPV was performed within 72 hours of symptom onset, irrespective of preceding intravitreal antibiotics injection; eye without PPV during this window comprised the injection-first comparison group.

The primary endpoint was logMAR best corrected visual acuity (BCVA) change at three months; secondary endpoints were absolute BCVA and BCVA change at one year. Multivariable linear regression identified independent outcome predictors.</p> <p>Eighty-four eyes were included (20 early PPV; 64 tap-and-inject). Despite worse baseline BCVA in the early PPV group (2.18 ± 0.36 vs. 1.62 ± 0.82 logMAR), three-month BCVA improvement was significantly greater (−1.28 ± 0.78 vs. −0.64 ± 0.89 logMAR; <i>p</i> = 0.01).