Skip to main content
SpringerLink
Log in

Zur Prophylaxe und Therapie der postoperativen Endophthalmitis

ESCRS-Studie und „Early Vitrectomy Study“ in der Kritik

Prophylaxis and therapy of postoperative endophthalmitis

Criticism of the ESCRS study and the Early Vitrectomy study

  • Medizin aktuell
  • Published:
Der Ophthalmologe Aims and scope Submit manuscript

Zusammenfassung

Die postoperative Endophthalmitis führt häufig zu einer erheblichen Visusminderung bis hin zum Verlust des Auges. Gelegentlich kommt es dann zu gerichtlichen Auseinandersetzungen, in deren Verlauf Studien zur Urteilsfindung herangezogen werden. Sowohl die ESCRS-Studie zur Prophylaxe als auch die „Early Vitrectomy Study“ zur Therapie der postoperativen Endophthalmitis weisen in wesentlichen Teilen erhebliche Mängel auf. Sie können daher nicht als Handlungsanweisung, Leitlinie oder gar in gerichtlichen Auseinandersetzungen verwendet werden.

Abstract

Postoperative endophthalmitis often leads to a substantial loss of vision and sometimes to loss of the eye. Occasionally this results in legal disputes during which medical studies will be consulted for reaching a verdict. Both the European Society of Cataract and Refractive Surgeons (ESCRS) study on prophylaxis and the Early Vitrectomy study on the therapy of postoperative endophthalmitis suffer from substantial deficits in essential areas. These studies cannot therefore be utilized as standard operating procedures and guidelines as well as in legal disputes.

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

Literatur

  1. Aaberg TM, Sternberg P Jr (2001) Trauma: principles and techniques of treatment. In: Ryan SR (Hrsg) Retina. Mosby, St. Louis, S 2400–2426

  2. Barry P, Seal DV, Gettinby G et al für die ESCRS Endophthalmitis Study Group: (2006) ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery. Preliminary report of principal results from a European multicenter study. J Cataract Refract Surg 32:407–410

    Article  PubMed  Google Scholar 

  3. Barry P, Behrens-Baumann W, Pleyer U, Seal D (2007) ESCRS Guidelines on prevention, investigation and management of post-operative endophthalmitis. European Society for Cataract and Refractive Surgery, 1–36

  4. Behrens-Baumann W (2008) Zur chirurgischen Prophylaxe der postoperativen Endophthalmitis nach Phakoemulsifikation. Eine kurze Übersicht (und Wertung). Klin Monatsbl Augenheilkd 225:924–928

    Article  PubMed  CAS  Google Scholar 

  5. Behrens-Baumann W, Augustin AJ, Dick B et al (2005) Leitlinie zur Prophylaxe und Therapie von Endophthalmitiden. Hyg Med 30:342–362, Erratum in Hyg Med (2005) 30:409

    Google Scholar 

  6. Caillon J, Juvin ME, Pirault JL, Drugeon HB (1989) Activité bactéricide de la Daptomycine (LY 146032) comparée à celle de la Vancomycine et de la Teicoplanine sur les bactéries à gram positif. Pathol Biol 37:540–548

    PubMed  CAS  Google Scholar 

  7. Chang DF, Braga-Mele R, Mamalis N et al (2007) Prophylaxis of postoperative endophthalmitis after cataract surgery. Results of the 2007 ASCRS member survey. J Cataract Refract Surg 33:1801–1805

    Article  PubMed  Google Scholar 

  8. Chee SP, Bacsal K (2005) Endophthalmitis after microincision cataract surgery. J Cataract Refract Surg 31:1834–1835

    Article  PubMed  Google Scholar 

  9. Ciulla TA (1999) Update on acute and chronic endophthalmitis. Ophthalmology 106:2237–2238

    Article  PubMed  CAS  Google Scholar 

  10. Doft BH, Weiskopf J, Nilsson-Ehle I, Wingard LB Jr (1985) Amphotericin clearance in vitrectomized versus nonvitrectomized eyes. Ophthalmology 92:1601–1605

    PubMed  CAS  Google Scholar 

  11. Durand ML (2002) The post-endophthalmitis vitrectomy study era. Arch Ophthalmol 120:233–234

    PubMed  Google Scholar 

  12. Egger SF, Huber-Spitzy V, Skorpik C et al (1994) Different techniques of extracapsular cataract extraction: bacterial contramination during surgery. Prospective study on 230 consecutive patients. Graefe’s Arch Clin Exp Ophthalmol 232:308–311

    Google Scholar 

  13. El-Massry A, Meredith TA, Aguilar HE et al (1996) Aminoglycoside levels in the rabbit vitreous cavity after intravenous administration. Am J Ophthalmol 122:684–689

    PubMed  CAS  Google Scholar 

  14. Endophthalmitis Vitrectomy Study Group (1995) Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intrravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Arch Ophthalmol 113:1479–1496

    Google Scholar 

  15. 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 

  16. Galloway G, Ramsay A, Jordan K, Vivian A (2002) Macular infarction after intravitreal amikacin: mounting evidence against amikacin. Br J Opthalmol 86:359–360

    Article  CAS  Google Scholar 

  17. Garat M, Moser CL, Martin-Baranera M (2009) Prophylactic intracameral cefazolin after cataract surgery. J Cataract Refract Surg 35:637–642

    Article  PubMed  Google Scholar 

  18. García-Sáenz MC, Arias-Puente A, Rodríguez-Caravaca G, Bañuelos JB (2010) Effectiveness of intracameral cefuroxime in preventing endophthalmitis after cataract surgery. J Cataract Refract Surg 36:203–207

    Article  PubMed  Google Scholar 

  19. Haider SA, Hassett P, Bron AJ (2001) Intraocular vancomycin levels after intravitreal injection in post cataract extraction endophthalmitis. Retina 21:210–213

    Article  PubMed  CAS  Google Scholar 

  20. Henry JC, Rozas D (1993) Bacterial growth from anterior chamber fluid aspirates using different irrigating solutions in phacoemulsification. Invest Ophthalmol Vis Sci 34:884

    Google Scholar 

  21. Jackson TL, Williamson TH (1999) Amikacin retinal toxicity. Br J Ophthalmol 83:1199–1200

    Article  PubMed  CAS  Google Scholar 

  22. Javitt JC, Vitale S, Canner JK et al (1991) National outcomes of cataract extraction. Endophthalmitis following inpatient surgery. Arch Ophthalmol 109:1085–1089

    PubMed  CAS  Google Scholar 

  23. Kain HL (1997) Prinzipien in der Behandlung der Endophthalmitis. Klin Monatsbl Augenheilkd 210:274–288

    Article  PubMed  CAS  Google Scholar 

  24. Kattan HM, Flynn HW Jr, Pflugfelder SC et al (1991) Nosocomial endophthalmitis survey. Current incidence of infection after intraocular surgery. Ophthalmology 98:227–238

    PubMed  CAS  Google Scholar 

  25. Keverline MR, Kowalski RP, Dhaliwal DK (2002) In vitro comparison of ciprofloxacin, ofloxacin, and povidone-iodine for surgical prophylaxis. J Cataract Refract Surg 28:915–916

    Article  PubMed  Google Scholar 

  26. Kim SY, Park YH, Lee YC (2008) Comparison of the effect of intracameral moxifloxacin, levofloxacin and cefazolin on rabbit corneal endothelial cells. Clin Exp Ophthalmol 36:367–370

    Article  Google Scholar 

  27. Kowalski RP, Karenchak LM, Warren BB, Eller AW (1998) Time-kill profiles of Enterococcus to antibiotics used for intravitreal therapy. Ophthalmic Surg Lasers 29:295–299

    PubMed  CAS  Google Scholar 

  28. Lockington D, Flowers H, Young D, Yorston D (2010) Assessing the accuracy of intracameral antibiotic preparation for use in cataract surgery. J Cataract Refract Surg 36:286–289

    Article  PubMed  Google Scholar 

  29. Mah FS (2007) Topical and intracameral antibiotics for cataract surgery. Eye World Suppl 1–3:7

  30. Mamalis N, Kearsley L, Brinton E (2002) Postoperative endophthalmitis. Curr Opin Ophthalmol 13:14–18

    Article  PubMed  Google Scholar 

  31. Masket S (2005) Is there a relationship between clear corneal cataract incisions and endophthalmitis? J Cataract Refract Surg 31:643–645

    Article  PubMed  Google Scholar 

  32. Masket S, Belani S (2007) Proper wound construction to prevent short-term ocular hypotony after clear corneal incision cataract surgery. J Cataract Refract Surg 33:383–386

    Article  PubMed  Google Scholar 

  33. Mistlberger A, Ruckhofer J, Raithel E, et al (1997) Anterior chamber contamination during cataract surgery with intraocular lens implantation. J Cataract Refract Surg 23:1064–1069

    PubMed  CAS  Google Scholar 

  34. Montan PG, Lundstrom M, Stenevi U, Thorburn W (2002) Endophthalmitis following cataract surgery in Sweden. The 1998 national prospective survey. Acta Ophthalmol Scand 80:258–261

    Article  PubMed  Google Scholar 

  35. Montan PG, Wejde G, Koranyi G, Rylander M (2002) Prophylactic intracameral cefuroxime. Efficacy in preventing endophthalmtis after cataract surgery. J Cataract Refract Surg 28:977–981

    Article  PubMed  Google Scholar 

  36. Motschmann M, Menkhaus S, Kuchenbecker J et al (1999) Ist der Zusatz eines Antibiotikums zur Spüllosung bei der Kataraktoperation sinnvoll? In: Duncker G, Ohrloff C, Wilhelm F (Hrsg) 12. Kongress der Deutschsprachigen Gesellschaft fur Intraokülarlinsen-Implantation und refraktive Chirurgie 1998. Springer, Berlin, S 111–118

  37. Nagaki Y, Hayasaka S, Kadoi C et al (2003) Bacterial endophthalmitis after small-incision cataract surgery. Effect of incision placement and intraocular lens type. J Cataract Refract Surg 29:20–26

    Article  PubMed  Google Scholar 

  38. Norregaard JC, Thoning H, Bernth-Petersen P et al (1997) Risk of endophthalmitis after cataract extraction: results from the International Cataract Surgery Outcomes study. Br J Ophthalmol 81:102–106

    Article  PubMed  CAS  Google Scholar 

  39. O’Brien TP, Arshinoff SA, Mah FS (2007) Perspectives on antibiotics for postoperative endophthalmitis prophylaxis: potential role of moxifloxacin. J Cataract Refract Surg 33:1790–1800

    Article  Google Scholar 

  40. Ozlem TY, Necati DM, Fatma YM et al (2010) Are cefuroxime and vancomycin really safe on the corneal endothelial cells? Graefe’s Arch Clin Exp Ophthalmol 248:415–410

    Google Scholar 

  41. Olson RJ (2008) Europeans, Americans split over intracameral cefuroxime use. A debate at ESCRS highlighted different attitudes toward intracameral cefuroxime use for cataract surgery prophylaxis. Ocular Surg News (Europe/Asia-Pacific-Edition); Januar:13–14

  42. Pleyer U, Mondino BJ, Adamu SA et al (1992) Immune response to Staphylococcus epidermidis endophthalmitis in a rabbit model. Invest Ophthalmol Vis Sci 33:2650–2663

    PubMed  CAS  Google Scholar 

  43. Rosen ES (2007) Safety first. J Cataract Refract Surg 33:1669–1671

    Article  PubMed  Google Scholar 

  44. Seal DV, Barry P, Gettinby G et al für die ESCRS Endophthalmitis Study Group (2006) ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery. Case for a European multicenter study. J Cataract Refract Surg 32:396–406

    Article  PubMed  Google Scholar 

  45. Seal DV, Reischl U, Behr A et al (2008) Laboratory diagnosis of endophthalmitis: Comparison of microbiology and molecular methods in the European Society of Cataract & Refractive Surgeons multicenter study and susceptibility testing. J Cataract Refract Surg 34:1439–1450

    Article  PubMed  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  47. Sternberg P Jr, Martin DF (2001) Mangaement of endophthalmitis in the Post-Endophthalmitis Vitrectomy Study era. Arch Ophthalmol 119:754–755

    PubMed  Google Scholar 

  48. Taban M, Behrens A, Newcomb RL et al (2005) Acute endophthalmitis following cataract surgery. Arch Ophthalmol 123:613–620

    Article  PubMed  Google Scholar 

  49. Thoms SS, Musch DC, Soong HK (2007) Postoperative endophthalmitis associated with sutured versus unsutured clear corneal cataract incisions. Br J Ophthalmol 91:728–730

    Article  PubMed  Google Scholar 

  50. Villada JR, Vicente U, Javaloy J, Alió JL (2005) Severe anaphylactic reaction after intracameral antibiotic administration during cataract surgery. J Cataract Refract Surg 31:620–621

    Article  PubMed  Google Scholar 

  51. Wallin T, Parker J, Jin Y et al (2005) Cohort study of 27 cases of endophthalmitis at a single institution. J Cataract Refract Surg 31:735–741

    Article  PubMed  Google Scholar 

  52. Yoeruek E, Spitzer MS, Saygili et al (2008) Comparison of in vitro safety profiles of vancomycin and cefuroxime on human corneal endothelial cells for intracameral use. J Cataract Refract Surg 34:2139–2145

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Augenheilkunde, Otto-von-Guericke-Universität, Leipziger Str. 44 (Haus 60b), 39120, Magdeburg, Deutschland

    W. Behrens-Baumann

Authors
  1. W. Behrens-Baumann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. Behrens-Baumann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Behrens-Baumann, W. Zur Prophylaxe und Therapie der postoperativen Endophthalmitis. Ophthalmologe 108, 1062–1066 (2011). https://doi.org/10.1007/s00347-011-2456-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00347-011-2456-0

Schlüsselwörter

Keywords

Search

Navigation