6 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 1 9
C
ataract
sur-
geons
contin-
ue to
live somewhat danger-
ously in their efforts to
prevent the rare but
dangerous infection of
post-op endophthalmi-
tis. Topical prophylaxis
remains the communi-
ty standard of care, but
an ever-growing num-
ber of surgeons feel
intracameral injections of antibiotics are more effective. But while that
method has largely been embraced in Europe, it presents a dilemma for
U.S. ophthalmologists.
Intracameral injections still aren't FDA-approved — and don't appear
likely to be any time soon — so their off-label use at this time could vio-
late community standards of care. In addition, pharmaceutical compa-
nies have shown little interest in providing single-use, sterile intracam-
eral antibiotics, so the drugs must be compounded. All this leaves eye
surgeons at a crossroads where using superior post-cataract infection
prevention potentially exposes them to medical and legal risk.
5 Things to Know About
Intracameral Antibiotics
They appear to be more effective than topical prophylaxis for preventing
endophthalmitis, but they're still not approved by the FDA.
Joe Paone | Senior Associate Editor
• EASY ON THE EYES Intracameral injections can reduce endophthalmitis rates and
eliminate the need for patients to apply post-op drops — but it's all being done off-
label.
Steve
Arshinoff,
MD,
FRCSC