Postoperative endophthalmitis after cataract surgery: a worldwide review of etiology, incidence and the most studied prophylaxis measures. (3rd September 2019)

• Record Type: Journal Article
• Authors: Grzybowski, Andrzej; Koerner, Jagger C.; George, Mary J.
• Is Part Of: Expert review of ophthalmology. Volume 14:Number 4/5(2019)
• Page Start: 247
• Page End: 257
• Publication Date: 2019-09-03
• Subjects: Post-operative endophthalmitis -- intracameral antibiotics -- povidone iodine -- endophthalmitis prevention -- endophthalmitis; Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1080/17469899.2019.1674140
• Languages: English
• ISSNs: 1746-9899

Abstract

ABSTRACT: Introduction : Endophthalmitis is a significant and potentially severe complication of cataract surgery. Cataract surgeons have several intraoperative prophylactic maneuvers to choose from to prevent this rare but serious complication. Areas covered : The epidemiology, etiology, and practice patterns regarding endophthalmitis prophylaxis are discussed; including a detailed review of the medications used intracamerally and use of povidone iodine. Articles were identified by PubMed literature search of published English-language articles. Literature in PubMed before June 2019 was reviewed without a date limit in the past. The terms 'intracameral antibiotic, ' 'povidone-iodine, ' 'moxifloxacin, ' 'vancomycin, ' 'cefuroxime, ' 'prophylaxis', and 'incidence' were combined with the terms 'prevention, ' 'endophthalmitis, ' and 'antisepsis protocol.' The reference lists of relevant articles were reviewed to identify additional articles, and this process was iterated several times. Expert opinion : The use of intracameral antibiotic prophylaxis (ICAP), after considering availability, cost and the postoperative endophthalmitis rate (POER) without ICAP, should be considered. Povidone iodine (PI) was shown to be an effective prophylactic measure against POE. Frequent topical application of dilute PI solution during surgery has an excellent safety profile, and significantly reduces the anterior chamber contamination rate after cataract surgery. Further studies of dilute PI in cataract surgery are needed.