Communications Medicine<\/a> on 16 July 2026.<\/p>\nAcute endophthalmitis is a rare but sight-threatening bacterial infection affecting the tissues and fluid inside the eye. It occurs in abound one in every 1,000 to 2,000 patients after eye surgery or intravitreal injections and can rapidly lead to severe vision loss or blindness if not effectively treated.<\/p>\n
The researchers said current treatment guidelines are largely based on evidence generated three decades ago following cataract surgery. Standard practice has generally involved repeated antibiotic injections into the eye, with vitrectomy reserved for patients who fail to improve.<\/p>\n
But they said advances in vitreoretinal surgery, including smaller gauge pars plana vitrectomy instruments, had improved wide-angle viewing systems and the routine use of silicone oil. This prompted researchers to revisit whether earlier surgery could improve outcomes.<\/p>\n
The EVIAN (Early Vitrectomy and Intravitreal Antibiotics for Post-operative Exogenous Endophthalmitis) trial enrolled 63 patients from 21 hospitals across the UK who developed endophthalmitis after any invasive ophthalmic procedure. Participants were randomly assigned to receive either early vitrectomy within 48 to 96 hours of diagnosis or conventional treatment with intravitreal antibiotics.<\/p>\n
Improved VA chart results<\/p>\n
Six months after treatment, patients in the early surgery group achieved a median improvement of 40 letters on a standard visual acuity chart, compared with a median improvement of 13 letters among those receiving the conventional antibiotic-first regimen.<\/p>\n
The researchers also found patients treated with early vitrectomy recovered vision sooner, potentially reducing both the physical burden of the painful infection and the psychological distress associated with uncertainty about permanent sight loss.<\/p>\n
Safety outcomes also favoured the surgical approach. Early vitrectomy was associated with fewer non-serious adverse events (47% versus 68%) and lower rates of retinal detachment than conventional management.<\/p>\n
Although the study was designed mainly to assess feasibility rather than definitively establish effectiveness, investigators said both patients and surgeons found the early intervention approach acceptable, supporting progression to a larger phase 3 trial.<\/p>\n
Lead author Associate Professor Mahi Muqit, from the UCL Institute of Ophthalmology and a senior vitreoretinal consultant at Moorfields Eye Hospital, said the findings suggest earlier surgery deserves further investigation.<\/p>\n
\u201cThis important new study shows the potential short-term and long-term potential benefits to patients given an early vitrectomy if they contract endophthalmitis after their eye procedure,\u201d he said.<\/p>\n
\u201cAs using this intervention at diagnosis shows clear potential to improve clinical outcomes, we now intend to take this forward to a definitive phase 3 randomised clinical trial that can definitively answer this question.\u201d<\/p>\n
The authors said the relatively small sample size means the findings require confirmation in a larger study before clinical practice changes. But, if confirmed, early vitrectomy could represent an important shift in treating a rare but devastating ophthalmic emergency, potentially preserving vision for patients who develop this serious postoperative complication.<\/p>\n","protected":false},"excerpt":{"rendered":"Performing vitrectomy soon after diagnosing acute bacterial endophthalmitis could deliver substantially better vision outcomes than the current antibiotic-first…\n","protected":false},"author":2,"featured_media":857906,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[64,63,137],"class_list":["post-857905","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-au","tag-australia","tag-health"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/857905","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=857905"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/857905\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/857906"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=857905"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=857905"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=857905"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}