Visual outcomes following the use of intravitreal steroids in the treatment of postoperative endophthalmitis

Objective: To compare visual outcomes between cases of acute postoperative endophthalmitis that did or did not receive intravitreal steroids. Design: Retrospective nonrandomized comparative trial. Participants: Fifty-seven patients with postoperative endophthalmitis. Intervention: Thirty-one patients with postoperative endophthalmitis resulting from cataract extraction received both intravitreal antibiotics and steroids, whereas the remaining 26 received only intravitreal antibiotics. Main Outcome Measures: Improvement in visual acuity. Results: Multivariate logistic regression was used to analyze the variables that potentially influence a three-line visual acuity improvement. The mean baseline visual acuities of both groups were comparable. The use of intravitreal steroids reduced the probability of developing a three-line improvement in visual acuity (odds ratio [OR] = 0.287; 95% confidence interval [CI] [0.072-0.852]). On the basis of logistic regression analysis using our multivariate model, gender, baseline visual acuity, and pars plana vitrectomy were not significantly associated with visual outcome differences between the two groups. Conclusions: Patients who received intravitreal steroids had a significantly reduced likelihood of obtaining a three-line improvement in visual acuity. At a minimum our study provides no support for their use and, therefore, steroids may not be efficacious for acute endophthalmitis related to cataract extraction. (C) 2000 by the American Academy of Ophthalmology.