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Endophthalmitis management study. Report #1. Protocol

To date, the Endophthalmitis Vitrectomy Study (EVS) has remained the hallmark of evidence-based management of acute bacterial endophthalmitis after cataract surgery with an intraocular lens. In the last quarter-century since its publication, several studies have reported that the microbiological spe...

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Autores principales: Das, Taraprasad, Dave, Vivek P, Dogra, Avantika, Joseph, Joveeta, Sharma, Savitri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8374761/
https://www.ncbi.nlm.nih.gov/pubmed/34146061
http://dx.doi.org/10.4103/ijo.IJO_199_21
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author Das, Taraprasad
Dave, Vivek P
Dogra, Avantika
Joseph, Joveeta
Sharma, Savitri
author_facet Das, Taraprasad
Dave, Vivek P
Dogra, Avantika
Joseph, Joveeta
Sharma, Savitri
author_sort Das, Taraprasad
collection PubMed
description To date, the Endophthalmitis Vitrectomy Study (EVS) has remained the hallmark of evidence-based management of acute bacterial endophthalmitis after cataract surgery with an intraocular lens. In the last quarter-century since its publication, several studies have reported that the microbiological spectrum of endophthalmitis is not the same across the world; there is emerging antibiotic resistance of gram-negative microorganisms to the EVS recommended antibiotics; there are newer molecules that could cross the blood-retinal barrier; the advances in vitreous surgery have become safer than before, and there are newer methods of microbiological evaluation. One of the often-mentioned drawbacks of the EVS was not recruiting grossly infected eyes with poor visibility of the iris and vitreous. Keeping these factors in mind, a new prospective multi-centered randomized study, the Endophthalmitis Management Study (EMS), is designed. The EMS will recruit all post-cataract surgery endophthalmitis patients irrespective of severity (including suspected fungal infection); the EMS will use quantifiable inflammatory score instead of the presenting vision to allocate for surgery, randomize the eyes to two different combinations of intravitreal antibiotics and use the newer microbiological diagnostic techniques. We believe the EMS findings will complement the EVS recommendations.
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spelling pubmed-83747612021-08-25 Endophthalmitis management study. Report #1. Protocol Das, Taraprasad Dave, Vivek P Dogra, Avantika Joseph, Joveeta Sharma, Savitri Indian J Ophthalmol Research Methodology To date, the Endophthalmitis Vitrectomy Study (EVS) has remained the hallmark of evidence-based management of acute bacterial endophthalmitis after cataract surgery with an intraocular lens. In the last quarter-century since its publication, several studies have reported that the microbiological spectrum of endophthalmitis is not the same across the world; there is emerging antibiotic resistance of gram-negative microorganisms to the EVS recommended antibiotics; there are newer molecules that could cross the blood-retinal barrier; the advances in vitreous surgery have become safer than before, and there are newer methods of microbiological evaluation. One of the often-mentioned drawbacks of the EVS was not recruiting grossly infected eyes with poor visibility of the iris and vitreous. Keeping these factors in mind, a new prospective multi-centered randomized study, the Endophthalmitis Management Study (EMS), is designed. The EMS will recruit all post-cataract surgery endophthalmitis patients irrespective of severity (including suspected fungal infection); the EMS will use quantifiable inflammatory score instead of the presenting vision to allocate for surgery, randomize the eyes to two different combinations of intravitreal antibiotics and use the newer microbiological diagnostic techniques. We believe the EMS findings will complement the EVS recommendations. Wolters Kluwer - Medknow 2021-07 2021-06-18 /pmc/articles/PMC8374761/ /pubmed/34146061 http://dx.doi.org/10.4103/ijo.IJO_199_21 Text en Copyright: © 2021 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Research Methodology
Das, Taraprasad
Dave, Vivek P
Dogra, Avantika
Joseph, Joveeta
Sharma, Savitri
Endophthalmitis management study. Report #1. Protocol
title Endophthalmitis management study. Report #1. Protocol
title_full Endophthalmitis management study. Report #1. Protocol
title_fullStr Endophthalmitis management study. Report #1. Protocol
title_full_unstemmed Endophthalmitis management study. Report #1. Protocol
title_short Endophthalmitis management study. Report #1. Protocol
title_sort endophthalmitis management study. report #1. protocol
topic Research Methodology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8374761/
https://www.ncbi.nlm.nih.gov/pubmed/34146061
http://dx.doi.org/10.4103/ijo.IJO_199_21
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