The use of adjunctive intravitreous corticosteroids in endophthalmitis is controversial. Preclinical models showed that early administration of corticosteroids may be important although they reported mixed results in terms of their effects on antibiotic pharmacokinetics, control of infection and prevention of retinal damage. Most published retrospective clinical studies showed no beneficial effects associated with their use. However, a single well-conducted retrospective study showed a deleterious effect. Randomized controlled trials also showed a lack of beneficial effects. At the present time, the best available evidences do not support the routine use of adjunctive intravitreous corticosteroids for treatment of acute endophthalmitis.

Aggressive treatment of filamentous fungal endophthalmitis with early surgical intervention, systemic antifungal therapy, and frequent intravitreal injections of voriconazole can result in excellent visual outcomes in some patients.

Purpose: This study examines the impact of corneal surface lubricants used during pars plana vitrectomy on corneal edema. Methods: This prospective, observational, clinical study occurred at an academic institution. Participants were individuals aged 18 years and older who had already consented to undergo pars plana vitrectomy, without pre-existing corneal pathology. A corneal lubricant was chosen by the surgeon. Corneal thickness was measured preoperatively and postoperatively using pachymetry and anterior segment optical coherence tomography (AS-OCT). Main outcome measure was change in corneal thickness as measured by pachymetry. Results: Forty-one patients completed the study protocol. The 23 subjects in the SHCS group had a significantly smaller increase in corneal thickness as measured by pachymetry compared with the 18 subjects in the HPMC group (29.9 μm vs. 58.1 μm, P value 0.02). When measured by anterior segment optical coherence tomography, the SHCS group had a smaller increase in corneal thickness compared with the HPMC group (0.04 mm vs. 0.06 mm, P value 0.09) but did not reach significance. Conclusion: SHCS is associated with reduced postoperative increase in corneal pachymetry as compared to HPMC.