Intracameral vancomycin following cataract surgery: An eleven-year study

Anijeet, Deepa; Palimar, Prasad; Peckar, C O

doi:10.2147/opth.s9546

Cited by 48 publications

(33 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An intracameral injection of antibiotics, including cefuroxime, vancomycin, and moxifloxacin, has been shown to be well tolerated and effective at reducing the rate of postoperative endophthalmitis [11–13,14 ▪▪ ,15 ▪▪ ,16 ▪ ,17 ▪ ]. In the case of vancomycin, a retrospective analysis of more than 16 000 cases showed that an intracameral injection of 1-mg vancomycin reduced the rate of postoperative endophthalmitis more than 37-fold [12]. Studies have also shown that an intracameral injection of vancomycin or moxifloxacin is well tolerated for the cornea and retina [18,19 ▪ ,20 ▪ ].…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes after injection of a compounded pharmaceutical for prophylaxis after cataract surgery

Tyson

Bailey

Roman

et al. 2017

Current Opinion in Ophthalmology

View full text Add to dashboard Cite

Purpose of reviewTo evaluate relevant clinical outcomes following a transzonular intravitreal injection of a compounded triamcinolone–moxifloxacin–vancomycin (TMV) formulation for postoperative prophylaxis after cataract surgery in a retrospective review of medical records from a private practice, single-specialty ambulatory center in New Jersey, USA.Recent findingsThe analysis included 1541 cases from 922 patients who underwent cataract surgery with an intravitreal injection of TMV from November 2013 to December 2014. Cataract surgery was performed by a standard clear corneal phacoemulsification technique. Transzonular injection was used to deliver TMV directly into the anterior vitreous after implantation of an intraocular lens.SummaryThere were no major intraoperative complications associated with the transzonular injection technique. There were no cases of postoperative endophthalmitis. Nearly 92% of cases (n = 1413/1541) did not require supplemental medication after surgery. The rate of breakthrough inflammation at Days 14–21 was 9.2% (n = 132/1429). The rate of visually significant postoperative cystoid macular edema was 2.0% (n = 28/1429). The rate of clinically significant postoperative intraocular pressure increase was low: 0.9% (n = 13/1425) of cases had an at least 10 mmHg increase at Days 14–21 or 90. Four of these cases had intraocular pressure at least 30 mmHg. The rates of infection and inflammation reported in this retrospective review of a transzonular injection of TMV for prophylaxis after cataract surgery appear similar to reported rates with alternative prophylactic therapies such as topical drops. The transzonular injection of TMV may have advantages in terms of patient compliance.

show abstract

Section: Introductionmentioning

confidence: 99%

Clinical outcomes after injection of a compounded pharmaceutical for prophylaxis after cataract surgery

Tyson

Bailey

Roman

et al. 2017

Current Opinion in Ophthalmology

View full text Add to dashboard Cite

show abstract

“…In order to reduce the risk of postoperative endophthalmitis, antibiotics have been used in irrigating fluid perioperatively43 44 or injecting intracamerally45 during cataract surgery. In the Centers for Disease Control and Prevention (CDC) guidelines for appropriate use of vancomycin46 and the report by the Rockefeller University Workshop47 published in 1994, the prophylactic use of vancomycin was discouraged in view of the risk of increasing the prevalence of VRE and MRSA.…”

Section: Discussionmentioning

confidence: 99%

Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility: literature review and options for treatment

et al. 2015

View full text Add to dashboard Cite

Background Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or resistance is an important clinical issue worldwide. Purpose To review the published literature on endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance. Methods The data were analysed from a PubMed search of endophthalmitis cases caused by Gram-positive organisms with reported reduced vancomycin susceptibility and/or vancomycin resistance from 1990 to 2015. Results From 18 publications identified, a total of 27 endophthalmitis cases caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance were identified. The aetiologies of endophthalmitis were exogenous in 19/27 cases (11 post-cataract surgery, 2 post-penetrating keratoplasty, 1 post-glaucoma surgery, 4 post-open globe injury, 1 post-intravitreal injection of ranibizumab), and endogenous in 4/24 cases; no details were available about the four remaining patients. The causative organisms included Enterococcus species (7/27), coagulase-negative staphylococci (4/27), Staphylococcus aureus (4/27), Bacillus species (4/27), Streptococcus species (3/27), Leuconostoc species (3/27), Staphylococcus hominis (1/27), and unidentified Gram-positive cocci (1/27). Visual acuity of 20/400 or better at the final follow-up was recorded in 10/26 patients (38.5%; data were not available for one patient). Treatment options include fluoroquinolones, penicillin, cephalosporins, tetracyclines, and oxazolidinones. Conclusions In the current study, visual acuity outcomes were generally poor. Enterococcus and Staphylococcus species were the most common organisms reported and postoperative endophthalmitis after cataract surgery was the most common clinical setting.

show abstract

“…8,61,62 Anijeet et al in a 11 year retrospective study of more than 16000 patients found that intracameral vancomycin (1mg in 0.1ml) reduced the incidence of endophthalmitis from 0.3% to 0.008%. 63 Vancomycin is very effective against gram positive bacteria including methicillin resistant staphylococcus aureus (MRSA) but is ineffective against gram negative bacteria. 8 There are concerns regarding intracameral vancomycin causing cystoid macular oedema and its limited microbial spectrum, that preclude its widespread use.…”

Section: Issn 0972-0200mentioning

confidence: 99%