Randomized Trial of Early Vitrectomy Feasible for Postoperative Endophthalmitis

MONDAY, Aug. 10, 2026 (HealthDay News) — For adults with postoperative endophthalmitis, conducting a randomized trial of early vitrectomy versus standard-of-care treatment is feasible, with benefit suggested for early vitrectomy, according to a study published online July 16 in Communications Medicine.

Mahiul M.K. Muqit, M.B.Ch.B., Ph.D., from Moorfields Eye Hospital NHS Foundation Trust in London, and colleagues conducted a multicenter, national prospective randomized controlled clinical trial to examine the feasibility of randomly assigning patients to an early vitrectomy intervention within 48 to 96 hours (arm A) compared with current standard patient care of repeated, immediate intravitreal antibiotic injection (arm B) and delayed vitrectomy. Participants were older than 18 years of age, with confirmed diagnosis of postoperative endophthalmitis and best corrected visual acuity (VA) worse than 35 ETDRS letters.

The researchers found that the study was feasible, and met the primary end point with 63 participants randomly assigned at a recruitment rate of 79 percent. From baseline to week 24, the median change in VA as per protocol was 40 versus 13 letters in arms A and B, respectively, corresponding to a between-group difference of 24 letters, in favor of early vitrectomy. Arm B had a higher rate of nonserious adverse events than arm A (68 versus 47 percent), with a higher incidence of retinal detachment (24 versus 6.7 percent, respectively).

“As using this intervention at diagnosis shows clear potential to improve clinical outcomes, we now intend to take this forward to a definitive phase 3 randomized clinical trial,” Muqit said in a statement.

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