Endophthalmitis prevention in Refractive Lens Exchange.
R Lorente, A Urcelay, A Sachkouskaya et al.
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In 30 seconds
This systematic review and meta-analysis evaluated intracameral vancomycin, cefuroxime, and moxifloxacin, and the added value of topical antibiotics for preventing endophthalmitis after phacoemulsification. Included studies supported intracameral antibiotics at the end of surgery. Findings favoured moxifloxacin and vancomycin over cefuroxime, but differences were not statistically significant. A secondary analysis found no additional preventive benefit from perioperative topical antibiotics when intracameral antibiotics and povidone-iodine were used. The abstract concludes that intracameral antibiotics are safe and effective, while noting that vancomycin use remains controversial.
Key findings
- All included studies supported intracameral antibiotic use at the end of phacoemulsification.
- Moxifloxacin and vancomycin had more favourable results than cefuroxime, without statistically significant differences.
- Perioperative topical antibiotics showed no additional benefit when intracameral antibiotics and povidone-iodine were used.
Why it matters
Endophthalmitis is a serious complication of phacoemulsification, and the review supports intracameral antibiotic prophylaxis as a preventive measure. Its findings also suggest that adding topical antibiotics may not improve prevention when intracameral antibiotics and povidone-iodine are already used, while the comparative evidence does not establish superiority among the assessed intracameral agents.
What to keep in mind
The review concerns cataract surgery by phacoemulsification; the abstract does not provide study counts, pooled effect estimates, or further details on the evidence base.