Toxicity, clearance, and therapeutic effectiveness of intravitreal vancomycin hydrochloride injection in experimentally induced staphylococcal endophthalmitis were evaluated. Vancomycin was found to be nontoxic in a single, 1 mg/0.1 ml intravitreal dose. Therapeutic levels of vancomycin were present in the vitreous for over 72 hours and in the aqueous during a period from 6 to 48 hours after injection. Injection of a methicillin-resistant Staphylococcus aureus produced a panophthalmitis in our systemically treated controls, whereas in the rabbits treated by intraocular injection, the course of the infection was significantly altered.

An experiment was designed to see if an aminoglycoside antibiotic, amikacin, would penetrate the vitreous of rabbits in greater concentrations in the postoperative aphakic eye than in the normal eye. Phakic and aphakic eyes were treated with amikacin by topical, subconjunctival, and intramuscular methods separately and combined. Bioassays of aqueous, anterior vitreous, and posterior vitreous revealed that concentrations of amikacin in ocular fluids after intramuscular administration were greater in the aphakic eye as compared to the normal eye; however, concentrations in the vitreous did not reach reliably bactericidal concentrations even when all three methods of administration were combined.

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Fifteen patients underwent a pars plana approach vitrectomy and membranectomy after acute and chronic injury. I n all cases the lens fragments, hemorrhage, and secondary membranes were removed restoring clarity to the ocular media. In two cases the final visual acuity was limited by preexisting retinal injury. The advantages of pars plana approach are the small incision and minimal ocular manipulation during surgery. In the presenre of retinal injury, diathermy during the procedure or photocoagulation within 24 hours is also indicated.

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