Douglas J. Rhee, MD

282. Immediate pars plana vitrectomy is beneficial if visual acuity on presentation is light perception or worse. 53. Often combined with topical, subconjunctival, and/or intravitreal steroids since fungi are unlikely in the early postoperativesetting. Use topical prednisolone acetate 1% Q1 hr and subconjunctival triamcinolone 40 mg at the time of vitrectomy.Intravitreal dexamethasone 0.4 mg at time of surgery is at surgeon’s discretion. Some have shown that concomitant use ofintravitreal steroids may yield a worse visual prognosis. 64. Topical atropine 1% TID is also given for cycloplegia.(1) Topical: Combination of fortified aminoglycoside with either fortifed cefazolin or vancomycin.Drug Dosagefortified cefazolin 4 OR fortified vancomycin 4 Q1 hr (alternate drops every 30 minutes)PLUSfortified gentamicin 4 OR fortified tobramycin 4 Q1 hr (alternate drops every 30 minutes)Notes: (2) Intravitreal1. Can be reinjected if the vitreous is not clearing.2. Ceftazidime is an alternative agent for Gram-negative coverage in bacterial endophthalmitis. 7Drug Dosageamikacin 0.2–0.4 mg in 0.1 mlORceftazidime 2.25 mg in 0.1 mlPLUSvancomycin 1.0 mg in 0.1 ml