Incidence of postoperative endophthalmitis from 1990 to 2009 using povidone–iodine but no intracameral antibiotics at a single academic institution

Nentwich, Martin M.; Ta, Christopher N.; Kreutzer, Thomas C.; Li, Bing; Schwarzbach, Fabian; Yactayo-Miranda, Yazmin M.; Kampik, Anselm; Kaspar, Herminia Miño de

doi:10.1016/j.jcrs.2014.04.040

Cited by 67 publications

(38 citation statements)

References 29 publications

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“…Since the top centers only account for 3.1% of the hospitals in China [statistics reported by the National Bureau of statistics of China (http://data.stats.gov.cn)], the results of the current survey are more representative of the present medical treatment level in most Chinese hospitals. In developed countries, the incidence of postoperative endophthalmitis ranges from 0.012 to 0.076%3456789, which is far less than in our study. Recently, the European Society of Cataract & Refractive Surgeons (ESCRS) recommended the intracameral injection of 1 mg of cefuroxime at the close of cataract surgery10.…”

Section: Discussioncontrasting

confidence: 73%

The occurrence rate of acute-onset postoperative endophthalmitis after cataract surgery in Chinese small- and medium-scale departments of ophthalmology

Zhu

Chen

et al. 2017

Sci Rep

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Endophthalmitis can be a devastating complication after cataract surgery. Therefore, this study sought to better understand the occurrence rate of acute-onset postoperative endophthalmitis after cataract surgery in Chinese small and medium-scale departments of ophthalmology, as well as identify its risk factors and assess the treatment options. This investigation revealed 52 postoperative endophthalmitis cases in 46,185 operations at 30 hospitals from 2011 to 2013, at an occurrence rate of 0.11%. A small cataract surgery volume of less than 500 cases per year (OR 2.21; p = 0.006), the absence of 0.5% povidone iodine (PVP-I) irrigation (OR 1.73; p = 0.046), and intraoperative posterior capsular rupture (PCR) with vitreous loss (OR 4.40; p = 0.034) showed statistically significant associations with endophthalmitis in the multivariate analysis. The rate of culture positivity was 44.2%, with Staphylococcus epidermidis being the most common organism isolated in China. More than 40% of the endophthalmitis cases were treated with a nonstandard antibiotics regimen, and only 32.7% of these had a visual acuity of better than 20/40. We concluded that the occurrence rate of acute-onset endophthalmitis following cataract surgery in Chinese small and medium-scale departments of ophthalmology lags behind the level of developed countries, as well as Chinese top eye centers. Overall, the use of 0.5% PVP-I irrigation seemed to be an effective measure to reduce the risk of the development of postoperative endophthalmitis.

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Section: Discussioncontrasting

confidence: 73%

The occurrence rate of acute-onset postoperative endophthalmitis after cataract surgery in Chinese small- and medium-scale departments of ophthalmology

Zhu

Chen

et al. 2017

Sci Rep

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“…The reported incidence of postoperative endophthalmitis after cataract surgery varies from 1 in 300 to 1 in 14,000 depending upon the geographic location and surgical techniques used [2, 3]. Besides sterile technique, other proven innovations that have decreased the incidence of endophthalmitis following cataract surgery include use of preoperative povidone/iodine cleansing solution and small incision phacoemulsification techniques [4, 5]. At the present time, there is no general consensus in regard to the effectiveness of topical antibiotics for reducing the rates of endophthalmitis after cataract surgery [6].…”

Section: Introductionmentioning

confidence: 99%

The Safety and Efficacy of Routine Administration of Intracameral Vancomycin during Cataract Surgery

Rush

2015

Journal of Ophthalmology

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Purpose. To evaluate the safety and efficacy of intracameral vancomycin during cataract surgery using a standardized dosage and delivery technique. Methods. The charts of 20,719 consecutive eyes that underwent phacoemulsification with intraocular lens implantation in a single ambulatory surgery center were retrospectively reviewed over a 5-year period. Results. The first 11,333 consecutive cases did not receive intracameral vancomycin, whereas the next 9,386 consecutive cases all received intracameral vancomycin. There were no significant differences in the baseline characteristics between the cohort of subjects who received intracameral vancomycin and the cohort of subjects that did not. There were a total of 11 subjects (0.97 cases per 1,000) that developed postoperative endophthalmitis in the group that did not receive intracameral vancomycin, whereas there were no cases of postoperative endophthalmitis in the group that received intracameral vancomycin (p = 0.0015). The overall rate of intraoperative and postoperative complications and the final postoperative visual acuities were similar among cohorts. There were no cases of toxic anterior segment syndrome occurring in either group during the study period. Conclusions. Routine administration of intracameral vancomycin during cataract surgery significantly decreased the incidence of postoperative endophthalmitis and was not associated with an increased incidence of postoperative adverse events.

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“…No intracameral antibiotics were used. 36 These rates are comparable to the group that received intracameral cefuroxime in the ESCRS study. 13 The above two studies thus found reduced incidence of endophthalmitis with increasing volumes and concentrations of povidone iodine.…”

Section: Peri-operative Measuresmentioning

confidence: 69%

A Review of Antibiotic Prophylaxis for Post-operative Endophthalmitis

Goray¹

2016

DJO

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Incidence of postoperative endophthalmitis from 1990 to 2009 using povidone–iodine but no intracameral antibiotics at a single academic institution

Abstract: No author has a financial or proprietary interest in any material or method mentioned.

Cited by 67 publications

References 29 publications

The occurrence rate of acute-onset postoperative endophthalmitis after cataract surgery in Chinese small- and medium-scale departments of ophthalmology

The occurrence rate of acute-onset postoperative endophthalmitis after cataract surgery in Chinese small- and medium-scale departments of ophthalmology

The Safety and Efficacy of Routine Administration of Intracameral Vancomycin during Cataract Surgery

A Review of Antibiotic Prophylaxis for Post-operative Endophthalmitis

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