Endophthalmitis: A Case for Acting Early

Trial suggests early vitrectomy could deliver faster and greater visual recovery for patients with acute endophthalmitis

September 3, 2026
3 min

The Ophthalmologist

Objective:

To assess the feasibility and potential benefits of early surgical intervention (vitrectomy) in patients with endophthalmitis following intraocular procedures.

Approach:

Study Design: A Phase 2 feasibility study involving 21 UK centers, randomized controlled trial comparing early vitrectomy (within 48–96 hours) to an initial antibiotic-led treatment strategy.

Key Findings:

Patients treated with early vitrectomy achieved a median improvement of 40 letters in visual acuity compared to 13 letters in the antibiotic-first group.
Recovery occurred sooner in the early-vitrectomy group.
Non-serious adverse events were reported in 47% of early vitrectomy patients versus 68% in the antibiotic-first group.
Fewer retinal detachments were observed in the early-surgery group.

Interpretation:

The study suggests that early vitrectomy may lead to better visual outcomes and quicker recovery in patients with endophthalmitis.

Limitations:

The study involved only 63 participants, limiting statistical power.
Findings are framed as feasibility rather than definitive evidence of superiority.