No consistency in endophthalmitis prophylaxis

Methods of attempting to prevent postoperative endophthalmitis vary widely across the United Kingdom, according to a study published in the May 2008 issue of Eye.

Patel Gordon-Bennett of the department of ophthalmology at Hinchingbrooke Hospital, Cambridgeshire, UK and colleagues conducted a telephone interview survey with 800 staff from ophthalmic training units across the UK between October and November 2005.

The team found that 99.4% of surgeons (n=795) used a preoperative preparation of povidone-iodine on the skin; 69.8% (n=558) instilled povidone-iodine into the conjunctival sac; and 5.9% (n=47) administered antibiotic eyedrops. During surgery, 17.8% (n=142) administered intracameral antibiotics: 66.4% (n=531) administered subconjunctival cefuroxime, 6.0% (n=48) administered routine gentamycin and 4.9% (n=39) administered alternative subconjunctival antibiotics; 16.8% (n=134) administered topical drops as a single dose. Combination steroid/neomycin drops were used by 64.4% of surgeons (n=515) postoperatively; 26.6% (n=213) administered separate drops.

The study revealed wide variation in the preventative measures employed by surgeons. The most frequently deployed methods of endophthalmitis prophylaxis are administrations of subconjunctival and intracameral cefuroxime.