Antibiotic prevention of postcataract endophthalmitis: a systematic review and meta-analysis
TLDR
High‐to‐moderate quality evidence is found for a marked reduction in the risk of endophthalmitis with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with theUse of topical antibiotics or intracAMeral vancomycin.Abstract:
Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one randomized trial and one observational study. The quality and design of the included studies were analysed using the Cochrane risk of bias tool. The quality of the evidence was evaluated using the GRADE approach. We found high-to-moderate quality evidence for a marked reduction in the risk of endophthalmitis with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to one of 485 surgeries when intracameral antibiotics were not used. The relative risk (95% CI) of endophthalmitis was reduced to 0.12 (0.08; 0.18) when intracameral antibiotics were used. The difference was highly significant (p < 0.00001). Intracameral antibiotic therapy is the best choice for preventing endophthalmitis after cataract surgery. We did not find evidence to conclude that topical antibiotic therapy prevents endophthalmitis.read more
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Journal ArticleDOI
Incidence of Acute Postoperative Endophthalmitis after Cataract Surgery: A Nationwide Study in France from 2005 to 2014
Catherine Creuzot-Garcher,Eric Benzenine,Anne-Sophie Mariet,Aurélie de Lazzer,Christophe Chiquet,Christophe Chiquet,Alain M. Bron,Catherine Quantin +7 more
TL;DR: The incidence of acute POE after phacoemulsification cataract surgery decreased from 0.145% to 0.053% during this 10-year period, and the use of intracameral antibiotics during the surgical procedures increased.
Journal ArticleDOI
Comparative analysis of the safety and efficacy of intracameral cefuroxime, moxifloxacin and vancomycin at the end of cataract surgery: A meta-analysis
Randy C. Bowen,Andrew Xingyu Zhou,Sailaja Bondalapati,Thomas W. Lawyer,Karisa B. Snow,Patrick Evans,Tyler Bardsley,Mary M McFarland,Matthew Kliethermes,Dallas Shi,Christina Mamalis,Tom Greene,Christopher J. Rudnisky,Balamurali K. Ambati +13 more
TL;DR: Intracameral cefuroxime and moxifloxacin reduced endophthalmitis rates compared with controls with minimal or no toxicity events at standard doses and may be as effective as intracameral plus topical antibiotics.
Journal ArticleDOI
Dose and administration of intracameral moxifloxacin for prophylaxis of postoperative endophthalmitis.
TL;DR: Intracameral moxifloxacin preparation as the final step in cataract surgery via the side port after the main incision has been sealed and hydrated showed advantages over alternative intracameral antibiotic prophylactic methods, with minimum risk.
Journal ArticleDOI
Endophthalmitis after cataract surgery: epidemiology, risk factors, and evidence on protection
TL;DR: Endophthalmitis prevention is at an interesting crossroad and the intracameral injection of antibiotics is increasingly being adopted by physicians, which is likely to grow further with commercial availability of formulations, but it is important to be cautious and report all adverse reactions associated with this practice.
Journal Article
Inflow of Ocular Surface Fluid Into the Anterior Chamber After Phacoemulsification Through Sutureless Corneal Cataract Wounds
L.H. Suh,Samantha Herretes,Walter J. Stark,Johann M.G. Reyes,Ashkan Pirouzmanesh,Peter J. McDonnell,Ashley Behrens +6 more
TL;DR: Tested sutureless corneal incisions allow inflow of extraocular fluid into the anterior chamber after phacoemulsification, which may permit intraocular contamination leading to endophthalmitis.
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Gordon H. Guyatt,Andrew D Oxman,Regina Kunz,Jan Brozek,Pablo Alonso-Coello,David Rind,Philip J. Devereaux,Victor M. Montori,Bo Freyschuss,Gunn Elisabeth Vist,Roman Jaeschke,John W Williams,Mohammad Hassan Murad,David A. Sinclair,Yngve Falck-Ytter,Joerg J Meerpohl,Craig Whittington,Kristian Thorlund,Jeffrey C Andrews,Holger J. Schünemann +19 more
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