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Graefe's Archive for Clinical and Experimental Ophthalmology
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 10/2019

01-10-2019 | Moxifloxacin | Cataract

Prophylactic intracameral cefazolin and postoperative topical moxifloxacin after cataract surgery: endophthalmitis risk reduction and safety results in a 16-year study

Authors: Carlos L. Moser, Monica Lecumberri Lopez, Magela Garat, Montserrat Martín-Baranera

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 10/2019

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Abstract

Purpose

This large retrospective observational study describes the evolution of the rates of postoperative endophthalmitis in cataract surgery in a 16-year period, and compares them before and after two different changes in the prophylaxis protocol of a general hospital in Barcelona, Spain.

Methods

This study included all the phacoemulsification procedures performed from January 2002 to December 2017. In January 2004, intracameral cefazolin at the end of the surgery was added to the prophylaxis protocol of cataract surgery. In January 2011, topical postoperative ofloxacin was replaced by topical moxifloxacin. Cumulative incidences of postoperative endophthalmitis before and after the addition of intracameral cefazolin and the change of ofloxacin by moxifloxacin as postoperative topical treatment were compared.

Results

The study included 55,984 surgeries. In the period after the introduction of intracameral cefazolin (2004–2010), the cumulative incidence of endophthalmitis was 0.047% (95% CI 0.019–0.099%), significantly lower than in the previous period. From January 2011 to December 2017, after the postoperative change of topical ofloxacin by moxifloxacin, the cumulative incidence dropped to 0.0037% (95% CI 0.000468–0.01862%), with a relative risk reduction between both periods of 91.3%.

Conclusion

An intracameral bolus of cefazolin was a very effective prophylaxis of endophthalmitis in cataract surgery. The continuous surveillance and prophylaxis protocol revision over time further reduced the incidence of this complication to extremely low levels.
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Metadata
Title
Prophylactic intracameral cefazolin and postoperative topical moxifloxacin after cataract surgery: endophthalmitis risk reduction and safety results in a 16-year study
Authors
Carlos L. Moser
Monica Lecumberri Lopez
Magela Garat
Montserrat Martín-Baranera
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 10/2019
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-019-04417-9

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