This article is more than 5 years old. Information may no longer be current.
Endophthalmitis prophylactic practices should be reviewed
Click Here to Manage Email Alerts
LAS VEGAS — A recent European study found strong evidence for the effectiveness of intracameral antibiotics in endophthalmitis prophylaxis, and physicians should review the results of the study to ensure they are following best practices, said Francis S. Mah, MD.
Dr. Mah discussed results of the study by members of the European Society of Cataract and Refractive Surgeons here at the OSN Las Vegas meeting. The study found that intracameral cefuroxime administered at the time of cataract surgery reduced the risk of developing endophthalmitis after surgery. The published data from the study included results in 13,698 patients.
Dr. Mah said caution is needed before altering one’s prophylactic regimen in cataract surgery. He noted that “the potential short- and long-term issues of intracameral antibiotics need to be examined.”
“Who knows if intracameral antibiotics may be associated with such diseases as glaucoma or age-related macular degeneration?” he asked.
Dr. Mah said there are other caveats regarding the use of cefuroxime, including a high rate of antibacterial resistance to the drug. The antibiotic “would not protect against any methicillin-resistant Staphylococcus aureus,” Dr. Mah said. He added that if all U.S. surgeons adopted use of intracameral cefuroxime in cataract surgery, this would result in “about $11 million per year in additional health costs.”
Furthermore, he said, the “potentially devastating” complication of toxic anterior segment syndrome could result from either the mislabeling or miscalculation of the amount of medication to be administered intracamerally.
Elizabeth A. Davis, MD, also discussed the ESCRS study at the meeting. She said that there was a “tremendous power” in the number of patients enrolled. However, she added that patients in the study had undergone surgery with many variations, as the surgical techniques used were not uniform.
The results of this study were published in the March 2006 issue of the Journal of Cataract and Refractive Surgery.