Anzeige
Erschienen in:
07.08.2019 | Cataract
Prophylactic intracameral cefazolin and postoperative topical moxifloxacin after cataract surgery: endophthalmitis risk reduction and safety results in a 16-year study
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 10/2019
Einloggen, um Zugang zu erhaltenAbstract
Purpose
This large retrospective observational study describes the evolution of the rates of postoperative endophthalmitis in cataract surgery in a 16-year period, and compares them before and after two different changes in the prophylaxis protocol of a general hospital in Barcelona, Spain.
Methods
This study included all the phacoemulsification procedures performed from January 2002 to December 2017. In January 2004, intracameral cefazolin at the end of the surgery was added to the prophylaxis protocol of cataract surgery. In January 2011, topical postoperative ofloxacin was replaced by topical moxifloxacin. Cumulative incidences of postoperative endophthalmitis before and after the addition of intracameral cefazolin and the change of ofloxacin by moxifloxacin as postoperative topical treatment were compared.
Results
The study included 55,984 surgeries. In the period after the introduction of intracameral cefazolin (2004–2010), the cumulative incidence of endophthalmitis was 0.047% (95% CI 0.019–0.099%), significantly lower than in the previous period. From January 2011 to December 2017, after the postoperative change of topical ofloxacin by moxifloxacin, the cumulative incidence dropped to 0.0037% (95% CI 0.000468–0.01862%), with a relative risk reduction between both periods of 91.3%.
Conclusion
An intracameral bolus of cefazolin was a very effective prophylaxis of endophthalmitis in cataract surgery. The continuous surveillance and prophylaxis protocol revision over time further reduced the incidence of this complication to extremely low levels.