How do you typically manage the use of intravitreal antibiotics during globe repair?
Answer from: at Community Practice
At the end of the case, if no allergies, I will inject vancomycin and ceftazidime intravitreal. If there was vegetable matter involved in the injury (tree branch), I would include an antifungal like voriconazole.
Comments
at Russellville Eye Clinic Pa Literature agrees with adding voriconazole only if...
Per the US military study, I use IV Levoquin at the time of surgery and several days after. I do not inject intravitreal antibiotics, unless there are clear signs of endophthalmitis. The vitrectomy and FB removal are the best ways to prevent post-vitrectomy infections. The solution to pollution is d...
If I am doing the globe repair, I will, but if the patient was referred to me after globe repair, then I don't do it unless there are signs of infection.
I inject intravitreal antibiotics if there is an intraocular foreign body, and add intravitreal antifungals if there is vegetable matter involved in the injury. I also inject if there are signs of endophthalmitis. Our department as a whole has a policy of admitting open globe patients for 48 hours o...
Preoperatively, I infuse IV Levaquin. At the end of the case, I inject intravitreal and subconjunctival vancomycin (1 mg) and ceftazidime (2.25 mg). If there was suspected vegetable matter involved, I would add an antifungal, like voriconazole, into the vitreous.
Literature agrees with adding voriconazole only if...