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Endophthalmitis after cataract surgery and effect of different intracameral antibiotic regimes in Sweden 2011-2017: national registry study
Karolinska Inst, Sweden; Capio Medocular, Sweden; Umea Univ Hosp, Sweden.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Memira Eye Ctr, Sweden.
Lund Univ, Sweden.
Karolinska Inst, Sweden; St Erik Eye Hosp, Sweden.
2024 (English)In: Journal of cataract and refractive surgery, ISSN 0886-3350, E-ISSN 1873-4502, Vol. 50, no 8, p. 828-835Article in journal (Refereed) Published
Abstract [en]

Purpose:To study the incidence, predictive factors, etiology, and visual consequences of postoperative endophthalmitis (PE) in relation to 3 intracameral (IC) antibiotic regimes. Setting:Swedish National Cataract Register entries from 2011 through 2017. Design:Observational retrospective study. Methods:PE incidence, influencing factors, bacteriology, and visual outcome were analyzed regarding the 3 major prophylactic IC protocols. Results:The overall incidence of PE was 0.023% or 177 cases in 764 513 cataract procedures. Analyzed per IC regime, the rates of PE were 0.024% (126 cases in 514 916 surgeries) for cefuroxime, 0.020% (25 cases in 122 340 surgeries) for moxifloxacin, and 0.017% (20 cases in 121 045 surgeries) for combined cefuroxime-ampicillin. Incidences were not statistically significantly different from one another. Gram-positive bacteria caused 89.0% of culture positive cases. Enterococci as pathogens were significantly more frequent with IC cefuroxime than with moxifloxacin, P = .006, or cefuroxime-ampicillin, P < .001, while streptococci other than enterococci were more common with moxifloxacin than with cefuroxime, P < .001. Bacterial susceptibility to the given antibiotics was demonstrated in 21.3% of PE cases treated with cefuroxime, which was statistically significantly lower than proportions found with cefuroxime-ampicillin, 60.0%, P = .015, or with moxifloxacin, 88.2%, P < .001. Visual outcome worse than 20/200 was similar in the groups ranging from 42.0% to 53.7%. Conclusions:No statistically significant differences in PE incidence or visual outcome results between treatment groups were demonstrated. However, differences in etiology and bacterial sensitivity were found between the prophylactic IC treatments.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2024. Vol. 50, no 8, p. 828-835
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-210072DOI: 10.1097/j.jcrs.0000000000001464ISI: 001356560200002PubMedID: 38661497OAI: oai:DiVA.org:liu-210072DiVA, id: diva2:1916457
Note

Funding Agencies|Kronprinsessan Margaretas Arbetsnamnd for synskadade, KMA

Available from: 2024-11-27 Created: 2024-11-27 Last updated: 2024-11-27

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