Bacterial endophthalmitis prophylaxis for cataract surgery

Climatic influence on conjunctival bacteria of patients undergoing cataract surgery

“…3 Among the many risk factors involved in the PE pathogenesis, [4][5][6][7][8][9][10][11] it is difficult to assess the weight of climatic influence; however, as conjunctival bacteria are the main source of contamination in cataract surgery, 12,13 it is quite logical to expect that the prevalence of conjunctival bacteria determines the prevalence of the infectious PE. Today, the world-wide use of povidona iodine solution as a preoperative prophylaxis in cataract extraction 14 could provide homogeneity in the kind of bacteria that produce PE all over the world, which was impossible to detect when a great number of different prophylactic techniques were used. 15,16 On the other hand, it is well known that climatic factors determine the incidence of conjunctivitis over the year in many parts of the world; 17 it is worth mentioning the study of the seasonal pattern of conjunctivitis in London, 18 which describes the responsible bacteria month by month.…”

Endophthalmitis, Prevention and Treatment

“…25 Povidine-Iodine as a prophylactic technique has been demonstrated to reduce the risk of endophthalmitis in a prospective study. Instillation of Povidine-Iodine should be instilled into the conjunctival sac and incorporate the lashes and surrounding periocular skin within the surgical field.…”

A Review of Antibiotic Prophylaxis for Post-operative Endophthalmitis

“…34 Ciulla et al in an evidence-based review of the literature on endophthalmitis prophylaxis, concluded that preoperative povidone-iodine prophylaxis was the single most effective means for reducing the risk for postoperative endophthalmitis. 24 Wykoff et al in a study from 2002 to 2009 used povidone iodine (5%) and achieved a lower rate of endophthalmitis (0.025%). 35 Nentwich et al studied the incidence of endophthalmitis from 1990 to 2009 at a single academic institution in Munich.…”

“…A systematic review by Ciulla et al concluded the efficacy of preoperative topical antibiotic prophylaxis was not yet scientifically proven. 24 The ESCRS 2007 guidelines cite preoperative topical antibiotic prophylaxis as an option to consider, 25 while the French 2011 guidelines do not recommend it. 26 Systemic Antibiotics: Schmitz et al surveyed more than 300000 eyes undergoing cataract surgeries and noted that addition of systemic antibiotics did not result in a significantly lower rate of postoperative endophthalmitis.…”