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Endophthalmitis prophylaxis controversial in US, not Europe
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CHICAGO — Intracameral antibiotics may be the future for endophthalmitis prophylaxis, but further research is needed, a speaker said here.
“It is controversial; it is difficult to do a large-scale study appropriately because of the low rate of infection, as well as multiple different variables that could be reintroduced,” Francis S. Mah, MD, said at Cornea Subspecialty Day preceding the American Academy of Ophthalmology meeting.
Francis S. Mah
In a prospective study surveying European Society of Cataract and Refractive Surgeons members, 74% of respondents reported using intracameral antibiotics. Among that percentage, 52% questioned scientific merit, 33% had concerns over compounding and 90% approved of the antibiotics as a commercial single-dose treatment method.
“The recommendation in many European countries is actually to use intracameral cefuroxime. As far as the U.S., we reported in 2007 that this may be a paradigm shift that we need for continued research, and in order for it to be effective, it has to be safe,” Mah said.
Intracameral antibiotics have shown statistically significant superiority over topical antibiotics in the ESCRS study, according to Mah.
“As far as intracameral antibiotics, there are convincing data in the last decade from various centers across the world, but there are still some legitimate concerns regarding the optimal drug,” Mah said.
Research on intracameral antibiotics should be continued to determine the optimal combination of drug and delivery method to eliminate postoperative endophthalmitis, Mah said.
Disclosure: Mah is a consultant for Alcon, Allergan, Bausch + Lomb, ForeSight, Imprimis, Nicox, Ocular Therapeutix, Omeros and Shire. Mah has received legal fees from Abbott, Allergan and Bausch + Lomb, and receives grant support from Alcon and Ocular Therapeutix.