The Endophthalmitis Vitrectomy Study (EVS) recommended immediate pars plana vitrectomy (PPV) over vitreous tap and inject for post-cataract endophthalmitis in which subset of patients?

• A All cases regardless of presenting visual acuity
• B Patients with presenting visual acuity of light perception only ✓
• C Patients with presenting visual acuity of hand movements or better
• D Patients with fungal endophthalmitis confirmed by culture

Explanation

The EVS (1995) is the landmark trial that compared immediate PPV versus vitreous tap/inject with or without systemic antibiotics in post-cataract endophthalmitis. The key finding was that in patients with vision reduced to light perception (LP), immediate PPV conferred a threefold benefit in achieving 20/40 or better vision (33% vs 11%) compared to tap alone. In patients with hand movements or better vision, the outcomes were equivalent between PPV and tap. The study also found no benefit from systemic antibiotics. This LP-threshold criterion is frequently tested.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.