The Effect of Continuous Intravitraal Irrigation(Lavaga) in Experimental Endophthalmitis

Kang, Se Woong; Lee, Sang Woo

Abstract

The prognosis of infectious endophthalmitis has improved considerably in recent years with refinements in early diagnosis, proper antibiotic therapy and vitreous surgery. But the disease is still potentially catastrophic in spite of proper intervention. The purpose of this study was to evaluate the effect of continuous intravitreal irrigation(lavage) after vitrectomy and lensectomy in intractable endophthalmitis. We injected cultured Pseudomonas(1.5 X 10(5)organism/0.1ml) into the anterior chamber or vitreous cavity of 11 rabbits. In both experimental group(8 eyes) and control group(3 eyes), vitrectomy and lensectomy was done 12 hours after inoculation. In the experimental group, silicone tube was installed thru pars plana sclerotomy site as an infusion and drainage port. Vitreous cavity was irrigated for 3 days with normal saline(1000 ml/day) mixed with amikacin (10 mg/day) and dexamethasone(60 mg/day) via this silicone tube. In the control group, we injected 0.1 ml amikacin(100 microgram/0.1 ml) into vitreous cavity at the end of operation and on daily basis for 3 days. Both groups underwent subconjunctival(25 mg/day) and intramuscular (25 mg/kg/day) injection of amikacin for postoperative 3 days. Electroretinograms of two experimental eyes were taken to evaluate retinal toxicity. On postoperative 7th day, all eyes were enucleated to evaluate inflammatory and toxic changes with light microscope. Electroretinograms of experimental eyes became extinguished on the 7th postoperative day. But we observed that the experimental group showed less inflammatory change than control group in the vitreous cavity and retina.