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Intracameral antibiotics prevent postoperative endophthalmitis
CHICAGO — Intracameral cefuroxime and moxifloxacin reduced the risk of endophthalmitis resulting from phacoemulsification, a speaker told colleagues here.
“Intracameral antibiotics are effective in reducing endophthalmitis risk,” Neal H. Shorstein, MD, said at the American Academy of Ophthalmology meeting. “Injections should eliminate the added risk due to failure of pharmacy dispensing or improperly administering topical drops.”
Shorstein presented the results of a retrospective cohort study including 129,077 eyes that underwent cataract surgery.
Cases involving complex surgery, as well as combined cataract and cornea procedures, were excluded from analysis. Data were adjusted for age, year of surgery, ocular and systemic comorbidities, posterior capsular rupture, and use of topical antibiotics.
Validated cases of postoperative endophthalmitis numbered 113, according to Shorstein.
Intracameral antibiotics were injected into about 40% of eyes. The posterior capsular rupture rate was 1.45% of the study population.
Eyes that received intracameral injection as well as topical drops were about half as likely to develop infection compared with eyes that received drops only, according to the presentation.
“The intracameral-only group had a similar adjusted odds ratio of infection; however, the confidence interval of this group was relatively wide,” Shorstein said.
Eyes injected with moxifloxacin had a slightly higher risk of endophthalmitis than eyes injected with cefuroxime, but again, the confidence interval was wide, according to Shorstein.
A clear comparison between cefuroxime and moxifloxacin in terms of efficacy is difficult to make, he said.
Disclosure: Shorstein has no relevant financial disclosures.