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Intracameral cefuroxime proves effective against endophthalmitis at one U.K. hospital
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STOCKHOLM, Sweden — The introduction of intracameral cefuroxime and povidone iodine wash at the end of surgery, as indicated by the ESCRS endophthalmitis study, has proven effective in significantly reducing the incidence of endophthalmitis at one hospital in England, according to a surgeon speaking here.
"Following a cluster of cases (nine in a 4-month period), certain changes were made since May 2004 to our protocol in terms of perioperative management, including disposable bimanual irrigation and aspiration handpieces [and] the use of intracameral cefuroxime and povidone iodine wash at the conclusion of the case," Richard Packard, MD, said at the European Society of Cataract and Refractive Surgeons meeting.
Of the 7,584 surgeries performed between May 2004 and April 2007 by 24 surgeons, only one patient developed culture-negative endophthalmitis. The patient recovered after intravitreal antibiotics and achieved unaided vision of 20/30 at 3 weeks postoperatively.
"This incidence of 0.013% is well below that reported in the peer-reviewed literature," Dr. Packard said. He noted that this low rate was obtained despite many surgeons of varying skill levels performing the surgery.
"Surgeons included six consultants, three associate specialists and 15 trainees of varying skills," he said.