1 0 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 • M A R C H 2 0 1 7
Could One "Little Squirt" Be All That's Needed?
INTRACAMERAL INJECTIONS
Two retrospective
studies suggest that
intracameral antibiot-
ic injections at the end
of cataract surgery
can prevent endoph-
thalmitis.
The first
(osmag.net/jdtm6j)
involved a California hospital that gradually increased its use of
intracameral injections of cefuroxime, moxifloxacin or van-
comycin during cataract surgeries between 2007 and 2011. As
injections increased, the number of endophthalmitis cases per
1,000 surgeries decreased from 3.13 in 2007, to 1.43 in 2008-9, to
0.14 in 2010-11.
The study also called into question whether topical antibiotics
reduce the likelihood of infection, says cataract and refractive sur-
geon T. Hunter Newsom, MD, founder of the Newsom Eye & Laser
Center in Tampa and Sebring, Fla. "In theory, you could just give
intracameral antibiotics and nothing else, and you'd be fine," he says.
Another study, done in France (osmag.net/xeg6fy), found that
administering antibiotics intracamerally — especially cefuroxime
— dramatically reduced the incidence of endophthalmitis.
Examining more than 5,000 patients who'd had cataract surgery,
the study found that only one of the roughly 2,300 who'd been
given intracameral cefuroxime developed endophthalmitis. But
among the roughly 2,800 who were not given the injection, 35
developed endophthalmitis. And no intraoperative factor was sig-
• ONE SHOT An intracameral antibiotic injection may be all that's needed to prevent endophthalmitis.
