Preop topical antibiotics helped prevent endophthalmitis, study shows

FORT LAUDERDALE, Fla. — Topical antibiotics applied before cataract surgery helped prevent endophthalmitis in a large series of cases, according to a presentation here at the Association for Research in Vision and Ophthalmology meeting.

D. A. Hollander, MD, and colleagues evaluated the role of preoperative topical antibiotics in the prophylaxis of bacterial endophthalmitis after cataract surgery. They reviewed 2,718 patients who underwent cataract surgery performed by residents between 1984 and 2002 at San Francisco General Hospital.

In 60% of cases, the patients applied antibiotic ointment to the ocular surface for 3 days prior to cataract surgery. The other 40% of patients did not apply preoperative antibiotics. All patients were prepped with povidone-iodine before surgery.

Three cases of postoperative bacterial endophthalmitis were seen in the patients who did not receive preoperative topical antibiotic treatment. Two cases were acute, presenting within 5 days of surgery, and both acute cases involved posterior capsular rupture and required anterior vitrectomy. No patients in the antibiotic treatment group developed endophthalmitis.

Dr. Hollander suggested that preoperative topical antibiotics may play a role in the prophylaxis of endophthalmitis, particularly in longer, complicated cases involving the disruption of the posterior capsule.