ASCRS members called upon for nationwide study on topical antibiotics

SAN FRANCISCO — Incoming ASCRS President Stephen S. Lane, MD, has proposed a nationwide study of the prophylactic use of topical antibiotics for the prevention of endophthalmitis after cataract surgery.

Although topical antibiotics are used routinely by many surgeons at cataract surgery, the regimen’s prophylactic efficacy has never proven, said Dr. Lane here in his speech accepting the presidency of the American Society of Cataract and Refractive Surgery.

“With the release of the newer, more potent, fourth-generation fluoroquinolones, the time is at hand to perform the definitive study, and ASCRS stands poised to do it,” said Dr. Lane.

In the study he proposed, each ASCRS member would be called on to participate, to obtain the approval of the institutional review board of their hospital or ASC, and to randomize their routine cataract patients to three treatment arms — gatifloxacin, moxifloxacin or levofloxacin — and placebo. Data will be collected online. Follow-up will be 1 month, which is the typical amount of time surgeons see patients postop.

Dr. Lane noted that the reason a study of this kind has not been done before is the tremendous number of patients needed to give the study statistical significance. The incidence of endophthalmitis is about 1 in 1,000 cataract cases.

“Think of it. A subspecialty society with its members as volunteer clinical investigators solving a decades-long controversy in less than 1 year at minimal cost,” he said. “Once again, though, we need your help. And I am confident you will come through when called upon, and we will finally have an answer to a question that will greatly serve society.”

Dr. Lane accepted his presidential medal from outgoing the ASCRS president, Marguerite B. McDonald, MD.