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21. Kongress der DGII 2007
Abstracts DGII 2007
R 15
Endophthalmitis prophylaxis – an ESCRS study
Barry P
The Eye Clinic Dublin (IRL)
Purpose: To determine the effects of antibiotic prophylaxis on the incidence of post operative endophthalmitis following phaco emulsification and to identify risk factors. Setting: 24 ophthalmology units in Austria, Belgium, Germany, Italy, Poland, Portugal, Spain, Turkey and the United Kingdom, with an administrative office in Ireland, co-ordinating centre in England, and a data management and statistical unit in Scotland. Methods: From September 2003 until January 2006 a total of 16,603 patients were recruited to the study which was prospective, randomised and partially masked. The study was based on a 2 × 2 factorial design and the study objective factors were intracameral cefuroxime and intensive perioperative topical levofloxacin drops. Results: 29 patients in total presented with acute postoperative endophthalmitis following cataract surgery and 20 of these were proven by gram stain, culture, or PCR. The benefit of intracameral cefuroxime as prophylaxis was overwhelming. The two principal risk factors were the use of a clear corneal incision and the use of a silicone intraocular lens. Intensive perioperative levofloxacin drops were not shown to be of benefit. Conclusion: The use of intracameral cefuroxime prophylactically at 1 mg in 0.1mls at the end of surgery reduces the occurrence of postoperative endophthalmitis. The utilisation of a clear corneal incision and the choice of a silicone intraocular lens both need to be reconsidered.
Erschienen in: Klin Monatsbl Augenheilkd, 224, Suppl. 2 |