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Effect of intracameral moxifloxacin in acute postoperative endophthalmitis incidence after phacoemulsification: cohort study and meta-analysis of prophylactic intracameral antibiotics

Poster Details

First Author: A.Tello COLOMBIA

Co Author(s):    V. Galvis   P. Camacho   M. Sánchez        

Abstract Details



Purpose:

To evaluate post-cataract surgery endophthalmitis rates in relation to prophylactic intracameral moxifloxacin administration. Meta-analysis of the literature reporting endophthalmitis incidence without and with intracameral antibiotics.

Setting:

Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Colombia.

Methods:

Patients who underwent phacoemulsification by a single surgeon from January 2007 through December 2011 were included. Two time periods were identified based on injection of prophylactic intracameral moxifloxacin. Incidence of presumed postoperative endophthalmitis during these 2 periods were calculated. Additionally we conducted a meta-analyis of publications comparing postoperative endophthalmitis rates with prophylactic intracameral antibiotics and without them, available by October 2012

Results:

During the inclusion period 2,067 patients (2,210 eyes) underwent cataract surgery. Rate of presumed infectious endophthalmitis after cataract surgeries between January 2007 and June 2009 (without intracameral moxifloxacin) was 0.094% (1/1,056 eyes). The rate in the second period, from July 2009 to December 2011 (with prophylactic intracameral moxifloxacin) was 0% (0/1,154 eyes). We identified 14 eligible published studies including 672.528 eyes, for the meta-analysis. Within the meta-analysis relative risk with the intervention was 0.31 in our study group, however the confidence interval was too wide. Overall analysis using both the Inverse variance method and the DerSimonian and Laird random-effects analysis showed a significant protective effect of the intracameral antibiotics

Conclusions:

In our patients a decline in the incidence of presumed infectious postoperative endophthalmitis seemed to be associated with the application of intracameral moxifloxacin. A meta-analysis of published comparative studies showed evidence to recommend prophylactic injection of intracameral antibiotics for endophthalmitis prevention.

Financial Disclosure:

NONE

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