Antibiotic Choice for the Prophylaxis of Post-Cataract Extraction Endophthalmitis

Rudnisky, Christopher J.; Wan, Darwin; Weis, Ezekiel

doi:10.1016/j.ophtha.2013.08.046

Cited by 60 publications

(62 citation statements)

References 24 publications

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“…28 However, it is controversial whether preoperative antibiotics or intracameral cefuroxime play a role in the routine prophylaxis of post-cataract endophthalmitis. [27][28][29][30][31][32][33][34] The majority of Italian cataract surgeons use topical fluoroquinolones in the perioperative period. In our survey, the use of perioperative antibiotics does not have a protective effect.…”

Section: Discussionmentioning

confidence: 99%

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Adherence to European Society for Cataract and Refractive Surgery Recommendations among Italian Cataract Surgeons: A Survey

Grosso¹,

Pertile

Marchini

et al. 2016

European Journal of Ophthalmology

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Section: Discussionmentioning

confidence: 99%

“…[28][29][30][31][32] Also, the efficacy and safety profile of intracameral cefuroxime during cataract surgery remain controversial since there are conflicting results in the literature about the additional protective effect of cefuroxime when added to the standard of care. 17,18,33,34 .…”

Section: Introductionmentioning

confidence: 99%

Adherence to European Society for Cataract and Refractive Surgery Recommendations among Italian Cataract Surgeons: A Survey

Grosso¹,

Pertile

Marchini

et al. 2016

European Journal of Ophthalmology

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“…8 A recent study by Rudinsky et al however documents no difference in the rate of endophthalmitis in patients with or without the administration of intracameral antibiotics (either vancomycin or moxifloxacin). 65 …”

Section: Issn 0972-0200mentioning

confidence: 99%

“…49 Rudinsky et al found no benefit of subconjunctival antibiotics (gentamycin, cefuroxime or cefazolin) in preventing endophthalmitis. 65 The ESCRS guidelines on endophthalmitis prophylaxis do not encourage the use of subconjunctival antibiotics due to their questionable efficacy and the proven superiority of intracameral cefuroxime. 13 Also the recent trend towards cataract surgery under topical anaesthesia makes subconjunctival antibiotic administration inconvenient.…”

Section: Subconjunctival Antibioticsmentioning

confidence: 99%

“…Although all patients in this study received post-operative topical antibiotics, the authors found a statistically significant (p=0.029) decrease in the rate of endophthalmitis when moxifloxacin was used (0.01%) as compared to when any one of the other antibiotics was used (0.04%) (ciprofloxacin, ofloxacin, gatifloxacin, polymyxin and tobramycin). 65 A recent meta-analysis of antibiotic prophylaxis of post cataract surgery endophthalmitis however, did not find any evidence favouring the use of post-operative antibiotics and hence the authors did not recommend this measure .4…”

Section: Post-operative Antibioticsmentioning

confidence: 99%

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A Review of Antibiotic Prophylaxis for Post-operative Endophthalmitis

Goray¹

2016

DJO

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Prophylactic Intracameral Antibiotics and Endophthalmitis After Cataract Surgery

van Rooij,

Nolte,

van de Vondervoort

et al. 2024

JAMA Ophthalmol

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ImportanceAlthough the effectiveness of intracameral antibiotics to prevent postoperative endophthalmitis is described, selective use of antibiotics combined with 1% povidone iodine disinfection might be equally effective and could lead to cost reduction and avoidance of unnecessary use of antibiotics.ObjectiveTo compare the incidence of postoperative endophthalmitis when 1% povidone iodine disinfection is applied in combination with selective intracameral antibiotics with the incidence after routine use of intracameral antibiotics in combination with 5% povidone iodine.Design, Setting, and ParticipantThis was a retrospective cohort study using incidence data from the ongoing endophthalmitis register of the Rotterdam Eye Hospital, a specialized hospital providing both secondary and tertiary ophthalmological care, when intracameral antibiotics were used only during cataract procedures with occurrence of a posterior capsular tear in comparison with results from cohorts described in the literature where routine antibiotics were used. All patients who had cataract (phacoemulsification) surgery at the Rotterdam Eye Hospital between 1993 and 2022 were included. No cataract surgical procedures combined with other intraocular procedures were included.ExposurePovidone iodine disinfection and intracameral antibiotics during cataract surgery either routinely or only in case of posterior capsular tears.Main Outcome and MeasurePostoperative endophthalmitis incidence.ResultsPostoperative endophthalmitis incidence after 56 598 cataract (phacoemulsification) surgical procedures in the Rotterdam Eye Hospital between 2016 and 2022 was 0.000 (95% CI, 0.000-0.000). A PubMed literature search until September 2023 with respect to the incidence of postoperative endophthalmitis after routine antibiotic prophylaxis yielded 37 publications with an overall postoperative endophthalmitis incidence of 0.000 (95% CI, 0.000-0.000).Conclusions and RelevanceNo difference was observed between the postoperative endophthalmitis incidence during the last 7 years in the Rotterdam Eye Hospital and the overall postoperative endophthalmitis incidence after routine intracameral antibiotics prophylaxis as described in the literature. Disinfection with 1% povidone iodine in combination with selective antibiotic prophylaxis may be equally effective as routine antibiotic use and 5% povidone iodine.

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Antibiotic Choice for the Prophylaxis of Post-Cataract Extraction Endophthalmitis

Cited by 60 publications

References 24 publications

Adherence to European Society for Cataract and Refractive Surgery Recommendations among Italian Cataract Surgeons: A Survey

Adherence to European Society for Cataract and Refractive Surgery Recommendations among Italian Cataract Surgeons: A Survey

A Review of Antibiotic Prophylaxis for Post-operative Endophthalmitis

Prophylactic Intracameral Antibiotics and Endophthalmitis After Cataract Surgery

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