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- W2007703312 abstract "We congratulate Tan et al.1 for reporting on their experience with antibiotic prophylaxis of pseudophakic endophthalmitis in an Asian population. Given the ethical concerns regarding future randomized trials on this subject, only large retrospective case series can confute or confirm the positive effect of intracameral cephalosporins for pseudophakic endophthalmitis prophylaxis that was established by the European Society of Cataract & Refractive Surgeons (ESCRS) endophthalmitis prophylaxis study.2 In Tan et al.'s study, of 50 177 eyes having cataract surgery, 20 638 received intracameral cefazolin. The authors found a significantly favorable effect of the intracameral cefazolin bolus over the subconjunctival cefazolin, in line with the results of a similar study.3 Commendably, the rate of endophthalmitis, already low in the control group (first series), became extremely low in the treated group—less than 0.01%. For a better understanding of the findings and to enable comparison with the available clinical evidence, the timeframe from surgery should be stated. The study enrolled only eyes with “recent” ocular surgery without quantifying the time from surgery. We remind Tan et al. that a 3-month interval from surgery was the timeframe in the ESCRS study.2 We also query the rationale for the simultaneous administration of cefazolin and gentamicin. With the spectrum being similar and the safety issues related to gentamicin administered subconjunctivally,4 as done in the Tan et al. study, is it justifiable to routinely add aminoglycosides only to cover for the very rare Pseudomonas cases? It would be helpful to know whether the authors saw any case of retinal toxicity in their large case series. Besides the absence of information on whether the samples were from aqueous or vitreous taps, we noted that 43% of cultures were negative for bacterial growth, which reinforces the recommendation to use a molecular biology technique for endophthalmitis specimens, as previously suggested.5" @default.
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- W2007703312 date "2012-09-01" @default.
- W2007703312 modified "2023-09-25" @default.
- W2007703312 title "Prophylaxis of pseudophakic endophthalmitis" @default.
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- W2007703312 doi "https://doi.org/10.1016/j.jcrs.2012.07.007" @default.
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