<i>Retracted</i>: Epidemiological evaluation of intraoperative antibiosis as a protective agent against endophthalmitis after cataract surgery

Krummenauer, Frank; Kurz, Sabine; Dick, H. Burkhard

doi:10.1002/pds.1165

Cited by 7 publications

(7 citation statements)

References 21 publications

(13 reference statements)

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“…31 Conversely, in the updated German study published in 2005, the risk of POE for sclerocorneal incisions, compared with clear corneal incisions, was not significantly smaller. 39 The authors explain the discrepancy between their current and previous reports is likely due to an increased familiarity with clear corneal incisions and an increased understanding of potential risk for POE. 39 A study performed at the Wills Eye Hospital found a higher rate of PCE with clear corneal incisions (0.13%) than with scleral tunnel incisions (0.05%), although the difference was not statistically significant.…”

Section: Risk Factors For Pcementioning

confidence: 75%

“…39 The authors explain the discrepancy between their current and previous reports is likely due to an increased familiarity with clear corneal incisions and an increased understanding of potential risk for POE. 39 A study performed at the Wills Eye Hospital found a higher rate of PCE with clear corneal incisions (0.13%) than with scleral tunnel incisions (0.05%), although the difference was not statistically significant. 40 A retrospective case series performed at the Bascom Palmer Eye Institute similarly reported no statistical difference between the rates of PCE seen in clear cornea phacoemulsification (0.05%) and other methods (0.02%).…”

Section: Risk Factors For Pcementioning

confidence: 75%

“…8 The updated German survey supported the previous result by reaffirming that intraoperative intraocular antibiotics had a significantly decreased risk ratio of 0.69 and subconjunctival antibiotics had also a significantly decreased risk ratio of 0.70 for POE. 69 Intracameral Antibiotics and Antibiotics in Irrigating Solution Antibiotics in irrigating solutions and intracameral antibiotics can decrease S. epidermis' adherence to intraocular lenses. 70 Vancomycin, or a combination of vancomycin and gentamicin, is the most commonly used antibiotic.…”

Section: Perioperative Prophylactic Antibioticsmentioning

confidence: 99%

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Perioperative Prophylaxis for Postcataract Extraction Endophthalmitis

Kim

Ali²,

Cremers³

et al. 2007

International Ophthalmology Clinics

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Section: Risk Factors For Pcementioning

confidence: 75%

Section: Risk Factors For Pcementioning

confidence: 75%

Section: Perioperative Prophylactic Antibioticsmentioning

confidence: 99%

See 1 more Smart Citation

Perioperative Prophylaxis for Postcataract Extraction Endophthalmitis

Kim

Ali²,

Cremers³

et al. 2007

International Ophthalmology Clinics

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“…Studies that have empirically explored costs associated with prophylactic antibiotic treatment have consistently identified benefits, although most of these studies and cost analyses were conducted outside the United States 21,42,43. Perhaps the most challenging aspect of understanding the effectiveness of antibiotic prophylaxis is that, as Gower et al point out,44 few studies have been powered sufficiently to detect differences in this fairly uncommon infection.…”

Section: Discussionmentioning

confidence: 99%

An updated estimate of costs of endophthalmitis following cataract surgery among Medicare patients: 2010–2014

Schmier

Hulme-Lowe

Covert

et al. 2016

OPTH

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BackgroundEndophthalmitis, which can occur after ophthalmic surgery, is an inflammation of the intraocular cavity and causes temporary or permanent vision impairment. However, little is known about the cost of treatment. The objective of this analysis was to update and expand upon the results of a previously published report that estimated the direct medical cost of treatment for endophthalmitis.MethodsRetrospective data analysis using 2010 through 2014 United States Medicare Limited Data Sets. Procedure codes were used to identify beneficiaries who underwent cataract surgery; demographic and clinical characteristics at the time of diagnosis were determined. Patients were stratified into cases (those who developed endophthalmitis) and controls (those who did not develop endophthalmitis) in the 3 months following surgery. Claims (ie, charges) and reimbursements (ie, costs) for cases and controls in the 6 months following cataract surgery were identified and compared. Results are presented in 2015 US dollars.ResultsOf a total of 153,860 cataract surgery patients, 181 were diagnosed with endophthalmitis following cataract surgery, at a rate of 1.2 per 1,000. Cases were more likely to be male and less likely to be white than controls; age was similar. Total medical claims and reimbursements as well as ophthalmic claims and reimbursements were significantly higher for cases compared with controls. Total reimbursements, adjusted for age, sex, and region, were $4,893 higher (83% greater) and adjusted ophthalmic reimbursements were $3,002 higher (156% greater) for cases than for controls. Claims and reimbursements were significantly higher across all types of Medicare cost components.ConclusionPostcataract surgery endophthalmitis is associated with a substantial cost. Successful prophylaxis with antibiotic agents would reduce the significant costs associated with treating endophthalmitis.

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“…A study of phacoemulsification in a population living in poor hygiene conditions from a peripheral hospital reported a postoperative infectious endophthalmitis incidence of 0.5%, 6 whereas a university-based study reported an incidence of 0.08%. 2,4 Yet, in addition to the ESCRS multicenter study, a 2005 report by Krummenauer et al 8 indicates a significant benefit from intraoperative intraocular antibiosis and the 2007 study by Lundstr€ om et al 5 suggests that the nonuse of intracameral cefuroxime is an independent risk factor for postoperative endophthalmitis. Our results show a marked variety in practice patterns, with only half the participants using intracameral cefuroxime, compliant with ESCRS guidelines.…”

Section: Discussionmentioning

confidence: 99%

Perioperative antibiotic prophylaxis during cataract surgery in Greece

Mataftsi¹,

Tsinopoulos²,

Tsaousis³

et al. 2011

Journal of Cataract and Refractive Surgery

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Wound leak has been demonstrated in 31% of clear corneal incisions (CCIs) at the conclusion of phacoemulsification surgery. 1 We describe a technique for effectively sealing a clear corneal wound with subsequent confirmation of a watertight seal.Clear corneal phacoemulsification is performed under topical anesthesia, and surgical ports are hydrated. If the wound is leaky, an air bubble is injected into the anterior chamber through the side port so the bubble's diameter is one third to one half the corneal diameter. The side port is rehydrated. The patient is asked to look in the direction opposite that of the leaky port (for a main port leak in a temporal route phacoemulsification, the patient would be asked to look nasally), causing the air bubble to float up and tamponade the incision internally (Video, available at http://jcrsjournal. org). This position is held for 15 seconds, and the patient is then asked to look straight ahead. The surgeon should carefully observe the bubble for constancy of size. If the bubble size remains constant, the wound is watertight. If the bubble size progressively increases for a few seconds, there is a leak from one of the ports. In this case, the leaking port is identified, the dynamic air bubble sealing procedure is repeated, and the bubble is reexamined for constancy of size. This technique obviates the need for repeated incision hydration and the risk for increased intraocular pressure.It has been demonstrated that CCIs have pouting inner lips, and these may be responsible for the imperfect watertight sealing by stromal hydration; up to 30% show a gape in the endothelial side on the first postoperative day. 2,3 In such a case, the gaping incision lips would need positive pressure to close, which an air bubble pushed against the inner ostium of the incision would provide by its buoyancy.In accordance with the Boyle law, the volume of the air bubble in the anterior chamber depends inversely on the pressure in the chamber. In the case of a leaking corneal wound, the pressure in the anterior chamber would decline and the air bubble would continue to expand. This is a definite indication of even a slight wound leak. Prominent among the techniques described to detect wound leak are direct observation of escaping air or aqueous, viewing the movement of any particles in the anterior chamber, and use ofpovidone-iodine 5% to perform an on-table Seidel test. 1These have drawbacks such as the high surface air tension giving the false impression of a watertight wound whereas it is only airtight, the risk of missing a minimal leak, or the need to use a potentially toxic chemical such as povidone that might be sucked into the anterior chamber. 1,4 Our technique obviates these disadvantages. Additionally, the air bubble used in our technique is too small to cause visual obscuration, pupillary block, or significant endothelial damage. REFERENCES1. Chee S-P. Clear corneal incision leakage after phacoemulsificationddetection using povidone iodine 5%. Int Ophthalmol 2005; 26:175-179 2. Fine H, ...

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Retracted: Epidemiological evaluation of intraoperative antibiosis as a protective agent against endophthalmitis after cataract surgery

Cited by 7 publications

References 21 publications

Perioperative Prophylaxis for Postcataract Extraction Endophthalmitis

Perioperative Prophylaxis for Postcataract Extraction Endophthalmitis

An updated estimate of costs of endophthalmitis following cataract surgery among Medicare patients: 2010–2014

Perioperative antibiotic prophylaxis during cataract surgery in Greece

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Retracted: Epidemiological evaluation of intraoperative antibiosis as a protective agent against endophthalmitis after cataract surgery

Cited by 7 publications

References 21 publications

Perioperative Prophylaxis for Postcataract Extraction Endophthalmitis

Perioperative Prophylaxis for Postcataract Extraction Endophthalmitis

An updated estimate of costs of endophthalmitis following cataract surgery among Medicare patients: 2010&ndash;2014

Perioperative antibiotic prophylaxis during cataract surgery in Greece

Contact Info

Product

Resources

About

An updated estimate of costs of endophthalmitis following cataract surgery among Medicare patients: 2010–2014