Intracameral antibiotics during cataract surgery: evidence and barriers

Current Opinion in Ophthalmology
Aravind Haripriya, David F Chang

Abstract

There is continuing debate regarding the safety, efficacy, and necessity of intracameral antibiotics to prevent postoperative endophthalmitis. We summarize the most recent evidence-based publications that either support or caution against this practice. Several additional large, international retrospective clinical studies found a significant reduction in endophthalmitis rates with intracameral antibiotic prophylaxis. Many surgeons are looking for alternatives to vancomycin for intracameral prophylaxis because of its association with the rare but sight-threatening complication of hemorrhagic occlusive retinal vasculitis. Although most efficacy data has been reported for intracameral cefuroxime, one of the largest clinical studies to date shows convincing efficacy with intracameral moxifloxacin prophylaxis. This same study reported a significant benefit with intracameral moxifloxacin following posterior capsular rupture, and surgeons should consider intracameral prophylaxis in these high risk cases. Despite mounting evidence that routine prophylaxis with intracameral cefuroxime and moxifloxacin reduce the endophthalmitis rate following cataract surgery, many surgeons have not adopted this practice. Reasons include lack of level ...Continue Reading

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Citations

Jun 18, 2018·Journal of Cataract and Refractive Surgery·David F ChangUNKNOWN Ophthalmic Instrument Cleaning and Sterilization Task Force
Feb 13, 2020·Journal of Cataract and Refractive Surgery·David F ChangDouglas J Rhee
Jul 4, 2020·Journal of Cataract and Refractive Surgery·Michael S RamosSunil K Srivastava
Aug 29, 2020·Cutaneous and Ocular Toxicology·Ferhan YilmazH Alper Bagriyanik
Jan 5, 2020·Eye·Peter J Morgan-Warren, Jiten B Morarji
Aug 11, 2020·Journal of Cataract and Refractive Surgery·Michael S RamosSunil K Srivastava
Oct 24, 2020·International Ophthalmology Clinics·Ella H Leung, Allister Gibbons
Jan 8, 2021·International Journal of Retina and Vitreous·Sukhum Silpa-ArchaJanine M Preble

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