Role of chloramphenicol eye drops for endophthalmitis prophylaxis following cataract surgery: Outcomes of institutional cessation

Tracing the barriers to decarbonising ophthalmology: A review

“…52,76 Likewise, post-operative topical antibiotic drops are not required after routine phacoemulsification with intracameral antibiotics, supported by multiple lines of evidence. 31,[77][78][79][80] In the United States, 24% of surgeons administering intracameral antibiotics have stopped prescribing postoperative topical antibiotics. 31 Another target for ophthalmic emissions reductions is increasing renewable energy use in surgical facilities.…”

“…A useful consensus statement from multiple American ophthalmic organisations has agreed that multi‐use bottles of topical medications are safe for use in the peri‐operative context, and can be used until they are empty, so single‐use sterile eye drops are wasteful and unnecessary 52,76 . Likewise, post‐operative topical antibiotic drops are not required after routine phacoemulsification with intracameral antibiotics, supported by multiple lines of evidence 31,77–80 . In the United States, 24% of surgeons administering intracameral antibiotics have stopped prescribing post‐operative topical antibiotics 31 …”

Reduce, reuse, recycle: In that order

“…Data on how technique and equipment affect IVI endophthalmitis rates is impossible for a doctor to collect prospectively. Large audits and registries can demonstrate the infection rate with different standardised systems, much like the data that allow us to cease topical antibiotics after cataract surgery 11–13 . Consensus can take time, but these documents are now emerging.…”

“…Large audits and registries can demonstrate the infection rate with different standardised systems, much like the data that allow us to cease topical antibiotics after cataract surgery. [11][12][13] Consensus can take time, but these documents are now emerging. The American Academy of Ophthalmology and allied organisations have an Ophthalmic Instrument Cleaning and Sterilisation task force, who issue clear and authoritative statements that it is safe to reuse instruments after autoclave sterilisation, and to use multi-use eye drop bottles around surgery.…”

Fighting infection

“…In a systematic review and meta‐analysis that covered 12 studies and approximately 1.5 million eyes, the incidence of postoperative endophthalmitis was significantly lower when intracameral antibiotics were used. Guo et al 13 undertook an analysis of just over 30 000 patients who had routine cataract surgery at a single institution, comparing a period when postoperative chloramphenicol eye drops were routinely prescribed with a subsequent interval when they were not. The investigators found no statistically significant difference in the risk of endophthalmitis between the two groups, supporting their move away from using postoperative antibiotic eye drops following routine cataract surgery.…”