Intracameral cefuroxime reduces endophthalmitis

The use of intracameral cefuroxime at the end of cataract surgery reduces the occurrence of postoperative endophthalmitis, according to the findings of a multicentre study carried out by the European Society of Cataract and Refractive Surgeons (ESCRS).

These findings were published in the June issue of the Journal of Cataract & Refractive Surgery, following on from their first presentation at last year's ESCRS congress in London, UK.

The prospective, randomized, partially masked multicentre study enrolled 16,603 patients from 24 ophthalmology units in Austria, Belgium, Germany, Italy, Poland, Portugal, Spain, Turkey and the United Kingdom. The study was based on a 2x2 factorial design, with intracameral cefuroxime and topical perioperative levofloxacin factors resulting in four treatment groups.

A total of 29 patients presented with endophthalmitis, of whom 20 were classified as having proven infective endophthalmitis. The absence of an intracameral cefuroxime prophylactic regimen at 1 mg in 0.1 ml normal saline was associated with a 4.92-fold increase in the risk for total postoperative endophthalmitis. Furthermore, the use of clear corneal incisions, compared with scleral tunnels, was associated with a 5.88-fold increase in risk in infection, whilst the use of silicone intraocular lens (IOL) material compared with acrylic was associated with a 3.13-fold increased risk.

It was concluded that intracameral cefuroxime use can reduce the risk of developing postoperative endophthalmitis and that other risk factors include clear corneal incisions and the use of silicone IOLs.