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Purpose To evaluate the efficacy of vitrectomy with vancomycin for the treatment of experimental Bacillus cereus endophthalmitis. Methods Endophthalmitis was initiated in rabbits via intravitreal injection of 100 CFU B. cereus. Treatment groups included included 25-gauge transconjunctival sutureless vitrectomy with intravitreal vancomycin (1 mg) or vancomycin alone. Groups were treated at 4 h, 5 h, or 6 h postinfection. At 48 h (for 4 h and 5 h groups) or 36 h (for the 6 h group) postinfection, eyes were analyzed by electroretinography, histology, and inflammatory cell counts. Results Treatment with vitrectomy/vancomycin at 4 h resulted in significantly greater retinal function compared to that of vancomycin alone. Intraocular inflammation following treatment at 4 h was minimal for both treatment groups. Treatment with vitrectomy/vancomycin or vancomycin alone at 5 h or 6 h postinfection resulted in similar levels of retinal function loss (i.e. >90%) and significant intraocular inflammation. Conclusions These results demonstrate that vitrectomy may be of therapeutic benefit in the treatment of B. cereus endophthalmitis, but only during the early stages of infection.

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