Endophthalmitis Prevention After Cataract Surgery

by: Yoshitsugu Inoue et al

The development of eye surgery techniques, especially for cataracts, has been very significant in recent years. Almost 100% of patients can regain sight after having cataract surgery.

In 2002, Ciulla et al, examines several bacterial endophthalmitis prophylaxis techniques most often used in cataract surgery. The results were surprising. None of prophylactic techniques were receiving the highest clinical recommendations, which is rank A (crucial to clinical outcomes). The only decent disinfectant technique, with the B Recommendation (moderately important to clinical outcomes) was the use of povidone-iodine (PI) disinfectant liquid. However, according to Meiji, PI was more toxic and allergenic for use in the eye compared to the use in other skin or mucosa. PI should not be used for ocular surface.

Although giving the topical antibiotics before surgery using C Recommendation (possibly relevant but not definitely related to clinical outcome), some reports indicated that the bacterial growth can be reduced with topical antibiotics before surgery.

The results of this study also showed that the application of three days levofloxacin eye drops before surgery was significantly more effective than the one hour or once a day applications. Giving antibiotics for 3 days before surgery seems much better in reducing the number of bacteria on the conjunctiva than being given for a short time. In addition, a synergistic effect between topical antibiotic and iodine before surgery seemed more promising with giving the levofloxacin more than one hour or one day. Additional effects resulted in the iodine component becoming more pronounced in levofloxacin recipients for 3 days. (Source: Ophthalmology Update, September 2008 Edition | Page 1-4)

The complete article (in Bahasa) can be downloaded from the files below.