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Endophthalmitis Prophylaxis Study, Report 2: Intracameral antibiotic prophylaxis with or without postoperative topical antibiotic in cataract surgery.
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- Author(s): Rathi, Varsha; Sharma, Savitri; Das, Taraprasad; Khanna, Rohit; Rathi, Varsha M; Khanna, Rohit C
- Source:
Indian Journal of Ophthalmology; Nov2020, Vol. 68 Issue 11, p2451-2455, 5p- Subject Terms:
PHACOEMULSIFICATION; ANTIBIOTIC prophylaxis; CATARACT surgery; ANTIBIOTICS; CEFUROXIME; SURGICAL site; PREVENTIVE medicine; BACTERIAL disease prevention; PREVENTION of surgical complications; CATARACT; RESEARCH; CLINICAL trials; RESEARCH methodology; SURGICAL complications; MEDICAL cooperation; EVALUATION research; ANTERIOR chamber (Eye); COMPARATIVE studies; EYE infections; ENDOPHTHALMITIS; BACTERIAL diseases; LONGITUDINAL method - Source:
- Additional Information
- Subject Terms:
- Abstract:
Purpose: Intracameral antibiotic in cataract surgery has shown level I evidence as prophylaxis for postoperative endophthalmitis. Not much is known if one should also use topical antibiotics after intracameral injection. The purpose of the study was to determine efficacy of intracameral antibiotic with and without postoperative topical antibiotic in reducing the incidence of acute endophthalmitis after cataract surgery in rural India.Methods: A.prospective comparative, non-randomized interventional study was designed in 15 rural centres in India. The study recruited 40,006 patients (n = 42,466 eyes), who underwent cataract surgery (phacoemulsification/small incision cataract surgery), and received intracameral antibiotic (cefuroxime/moxifloxacin). Postoperative topical antibiotic prescription was left to the choice of the treating physician, but they were encouraged not to use it in uneventful surgeries. Primary outcome measure was occurrence of acute clinical endophthalmitis within 6 weeks of surgery. Statistical analysis was done using STATA software v13.1 (StataCorp, Texas); P value of <0.05 was considered statistically significant.Results: In the study, 17,932 (42%) eyes received intracameral cefuroxime (ICC) and 24,534 (58%) eyes received intracameral moxifloxacin (ICM). Topical antibiotic was not prescribed to 17,855 (42%) eyes - 5723 (32%) eyes in ICC group and 12,132 (68%) eyes in ICM group. Acute clinical endophthalmitis occurred in 15 (0.035%) eyes - 1 / 3515 (0.028%) eyes and 1 / 2231 (0.045%) eyes that received and did not receive topical antibiotic, respectively. The difference in occurrence of endophthalmitis with/without topical antibiotics in each group (ICC: 0.016% and 0.017%; P = 0.958; ICM: 0.040% and 0.058%; P = 0.538) was not significant (P = 0.376).Conclusion: Supplementing intracameral antibiotic with topical antibiotic postoperatively did not impact the occurrence of acute post cataract surgery endophthalmitis in rural India. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of Indian Journal of Ophthalmology is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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