Skip to main content
SpringerLink
Log in

Impact of intracameral cefuroxime on the incidence of postoperative endophthalmitis following cataract surgery in Ireland

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Postoperative endophthalmitis (PE) is a rare complication of cataract surgery, but carries a significant risk of blindness. The European Society of Cataract and Refractive Surgeons published a landmark study in 2007 that revealed the use of intracameral cefuroxime as prophylaxis against endophthalmitis reduced its incidence by fivefold. Since the publication of these results, the use of intracameral cefuroxime in cataract surgery has become a standard practice in many institutions, including our own.

Aim

To identify the incidence rate of PE among patients undergoing cataract surgery over the 4-year period following the introduction of prophylactic intracameral cefuroxime for cataract surgery.

Methods

A retrospective case note review of all cases of postoperative endophthalmitis that occurred between 2007 and 2011 was performed. Our results were compared with an earlier report on PE incidence rates from our institution that was conducted prior to the introduction of intracameral cefuroxime and published in 2001.

Results

There were five reported cases of endophthalmitis from 2007 to 2011 from a total of 8,239 cataract procedures, giving an incidence rate of 0.06 %. This compares with an incidence rate of 0.49 % in the earlier study prior to the introduction of intracameral cefuroxime and represents an eightfold reduction in the incidence of PE at our hospital. Of the five cases, three were confirmed on culture and sensitivity (two of which were due to Coagulase negative staphylococci and one due to Pseudomonas aeruginosa).

Conclusion

The incidence of postoperative endophthalmitis has reduced by approximately eightfold since the introduction of intracameral cefuroxime following cataract surgery at our hospital in 2007. This study strongly supports the use of intracameral cefuroxime as prophylaxis against endophthalmitis in all cataract surgical cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. ESCRS Endophthalmitis Study Group (2007) Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg 33:978–988

    Article  Google Scholar 

  2. Isenberg SJ, Apt L, Yoshimori R, Khwarg S (1985) Chemical preparation of the eye in ophthalmic surgery IV. Comparison of povidone–iodine on the conjunctiva with a prophylactic antibiotic. Arch Ophthalmol 103:1340–1342

    Article  CAS  PubMed  Google Scholar 

  3. Speaker MG, Menikoff JA (1991) Prophylaxis of endophthalmitis with topical povidone–iodine. Ophthalmology 98:1769–1775

    Article  CAS  PubMed  Google Scholar 

  4. Ng JQ, Morlet N, Bulsara MK, Semmens JB (2007) Reducing the risk for endophthalmitis after cataract surgery: population based nested case–control study: endophthalmitis population study of Western Australia Sixth report. J Cataract Refract Surg 33(2):269–280

    Article  PubMed  Google Scholar 

  5. Khan RI, Kennedy S, Barry P (2005) Incidence of presumed postoperative endophthalmitis in Dublin for a 5-year period (1997–2001). J Cataract Refract Surg 31:1573–1581

    Google Scholar 

  6. Garcia-Saenz MC, Arias-Puente A, Rodgriguez-Caravaca G, Banuelos JB (2010) Effectiveness of intracameral cefuroxime in preventing endophthalmitis after cataract surgery: 10 year comparative study. J Cataract Refract Surg 36(2):203–207

    Article  PubMed  Google Scholar 

  7. der Merwe Van, Mustak H, Cook C (2012) Endophthalmitis prophylaxis with intracameral cefuroxime in South Africa. J Cataract Refract Surg 38:2054

    Article  Google Scholar 

  8. Tan CS, Wong HK, Yang FP (2012) Epidemiology of postoperative endophthalmitis in an Asian population: 11 year incidence and effect of intracameral antibiotic agents. J Cataract Refract Surg 38(3):425–430

    Article  PubMed  Google Scholar 

  9. Pinna A, Usai D, Sechi LA, Zanetti S, Jesudasan NC, Thomas PA, Kaliamurthy J (2009) An outbreak of endophthalmitis caused by P. aeruginosa. Ophthalmology 116(2):2321–2326

    Article  PubMed  Google Scholar 

  10. Elfrig CWG, Scott IU, Flynn HW, Miller D (2003) Endophthalmitis caused by P. aeruginosa. Ophthalmology 110(9):1714–1717

    Article  Google Scholar 

  11. Endophthalmitis Vitrectomy Study Group (1995) Results of the endophthalmitis vitrectomy study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of post-operative bacterial endophthalmitis. Arch Ophthalmol 113:1479–1496

    Article  Google Scholar 

  12. McDonald M, Brondeau JM (2010) Emerging antibiotic resistance in ocular infections and the role of fluoroquinolones. J Cataract Refract Surg 36(9):1588–1598

    Article  PubMed  Google Scholar 

  13. O’hEineachain R (2012) Endophthalmitis. Intracameral antibiotics becoming standard practice among European cataract surgeons. EUROTIMES 17/18(12/1)

  14. Delyfer MN, Rougier MB, Leoni S et al (2011) Ocular toxicity after intracameral injection of very high doses of cefuroxime during cataract surgery. J Cataract Refract Surg 37(2):271–278

    Article  PubMed  Google Scholar 

  15. Cakir M, Imamglu S, Cekic O et al (2009) An outbreak of early-onset endophthalmitis caused by Fusarium species following cataract surgery. Curr Eye Res 34(11):988–995

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Royal College of Surgeons in Ireland, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland

    N. Rahman & C. C. Murphy

Authors
  1. N. Rahman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. C. Murphy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Rahman.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rahman, N., Murphy, C.C. Impact of intracameral cefuroxime on the incidence of postoperative endophthalmitis following cataract surgery in Ireland. Ir J Med Sci 184, 395–398 (2015). https://doi.org/10.1007/s11845-014-1127-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-014-1127-y

Keywords

Search

Navigation