Klebsiella Cluster Endophthalmitis following Intravitreal Bevacizumab: Role of Early Detection, Pars Plana Vitrectomy, and Intracameral Moxifloxacin

ABSTRACT

Aim

To report the clinical profile, outcomes of early vitrectomy for cluster endophthalmitis developing after intravitreal Bevacizumab (IVB), and discuss the role of prophylactic intracameral moxifloxacin for eyes undergoing combined cataract surgery with IVB.

Methods

Single center, retrospective analysis of 35 consecutive eyes developing post-IVB inflammation.

Results

Of the 35 eyes that were administered IVB (27 eyes ‘IVB alone’ and 8 eyes ‘IVB with cataract surgery’). Endophthalmitis developed in 28 eyes, 6 eyes were managed with Intravitreal antibiotic (IVAB) alone, while 22 eyes required early vitrectomy. Only one eye undergoing a combined phacoemulsification with IVB developed endophthalmitis. Majority(26/28) of the eyes achieved visual acuity equal to/greater than pre-IVB injection vision over a period of 3.15 ± 3.2 months.

Conclusion

Early detection and prompt PPV were effectual for achieving good functional outcomes in our cluster of post-IVB Klebsiella endophthalmitis. Intracameral moxifloxacin was protective in cases undergoing combined cataract surgery with IVB.

KEYWORDS:

• Vitrectomy in Klebsiella cluster endophthalmitis

Declaration Of Interest

The authors report no conflicts of interest.