Clinical Trials

Question 1

Endophthalmitis Vitrectomy Study (EVS)

Year & Purpose

Methods

Results

Key Points

Answer 1

• 1995, examine role of initial PPV with IVT Abx for acute post-op endophthalmitis
• Randomized multi-center trial, 420 pts
  
  • endophthalmitis w/in 6 weeks of CEIOL (95%) or secondary IOL (5%)
  • PPV or Tap, with or without IV Abx within 6 hrs of presentation
  • AC tap
  • IVT vanc/amikacin and subconj vanc/ceftaz/dex
  • IV Abx: ceftaz and amikacin for 5-10 days
  • Primary end point: BCVA and media clarity @ 3m & 12m
• ​No statistically significant difference amongst treatment groups
  
  • 94% of attributed to coag negative staph
  • subgroup analysis: LP or worse did better with PPV/INJ
    
    • 3x incease in BCVA >20/40
    • 2x incease in BCVA >20/100
    • 1/2 risk in BCVA >20/200
  • media clarity superior with PPV/INJ at 3m & 12m from baseline
• Key Points

1. Current standard is vanc/ceftaz, ceftaz for Gram - coverage, amikacin has retinal toxicity, IV abx no clear visual benifit
2. HM or better TAP/INJ
3. LP or worse PPV/INJ

Question 2

Ranibizumab and Bevacizumab for Wet AMD (CATT)

Year & Purpose

Methods

Results

Key Points