The Effect of Intraoperative Antibiotics in Irrigating Solutions on Aqueous Humor Contamination and Endophthalmitis after Phacoemulsification Surgery

Abstract

Intraoperative antibiotic irrigation decreases aqueous humor contamination during phacoemulsification. Further studies are warranted to determine the interrelationship between aqueous humor contamination and endophthalmitis in eyes with posterior capsular rupture.

Endophthalmitis Following Cataract Surgery: Clinical Features, Treatment and Prophylaxis

“…A prospective study demonstrated that the addition of moxifloxacin drops had no significant effect in the preoperative reduction of conjunctival bacterial colonization above the effect of povidoneiodine 5% alone (Halachimi-Eyal et al, 2009). Antibiotics in the irrigating fluid for cataract surgery have been reported to reduce anterior chamber bacterial contamination rates significantly but their effect on endophthalmitis prevention is less convincing (Sobaci et al, 2003;Srinivasan et al, 2008). The reported lack of effectiveness of both vancomycin and gentamicin in the irrigation fluid may be due to the requirement of more than 140 minutes to exhibit bactericidal effect, whereas the half-life of antibiotics in the anterior chamber is only 51 minutes (Gritz et al, 1996).…”

Comparação do efeito nas culturas de humor aquoso de gatifloxacina 0,3% aplicado três dias antes de facoemulsificação e e antes do pré-operatório

“…Alguns dos métodos de profilaxia já foram descritos: iodopovidona imediatamente antes do procedimento, uso de antibióticos imediatamente antes do procedimento, uso de antibióticos depois do procedimento e combinações destes métodos com diferentes formas de administração (subconjuntival, intracameral, tópico) (1,3,4) . As quinolonas de quarta geração estão disponí-veis no mercado há dois anos e apresentam espectro de ação duplo contra bactérias gram-negativas e gram-positivas, incluindo as bactérias mais comuns detectadas como causas de endoftalmite após cirurgia de catarata (5) .…”

Perioperative antibiotics for prevention of acute endophthalmitis after cataract surgery.

“…All four studies randomized participants, but random sequence generation and allocation concealment were described fully only in ESCRS 2007. Hence, we cannot judge whether some selection bias may have occurred in the Christy 1979, Christy 1986and Sobaci 2003 studies.…”

“…In the study judged as having a high risk of bias, eyes of participants for which the surgical procedure was modified according to physician discretion during surgery were excluded from the study (Sobaci 2003). Reasons for modifying the protocol included administering subconjunctival antibiotics and adding a suture.…”