Comparison between intracameral ceftazidime & cefuroxime for the prevention of post-operative endophthalmitis

Authors

  • Arooj Amjad Lahore General Hospital Lahore
  • Muhammad Moin

DOI:

https://doi.org/10.36351/pjo.v34i2.907

Keywords:

Endophthalmitis, Antibiotics, Cataract Surgery, Cefuroxime, Ceftazidime.

Abstract

Purpose: To compare the efficacy and safety of intracameral injection of ceftazidime and cefuroxime during cataract surgery for the prevention of post-operative endophthalmitis.

Study Design: Quasi experimental study.

Place and Duration of Study: Ophthalmology Department Unit-1, Lahore General Hospital, Lahore.

From November 2016 to March 2018.

Material and Methods: Patients undergoing cataract surgery in the eye department were selected by convenient sampling to receive prophylactic intracameral antibiotics at the end of routine cataract surgery. Patients were divided into two groups; group A received Cefuroxime and group B received Ceftazidime both as 1 mg /0.1ml intracameral injections at the end of the surgery after wound hydration and before chamber formation. The patients were examined pre and post operatively on slit lamp and the number of cells in the anterior chamber (A/C) were counted on day 1, week 1 and week 6 after surgery.

Results: Out of total 260 patients 130 were allocated to each group. On first post-operative day in Group A, A/C cell counts were grade 1 in 22 patients, grade 2 in 93 patients, grade 3 in 14 patients and Grade 4 in 1 patient. In group B, A/C cell counts were grade 1 in 11 patients, grade 2 in 96 patients, grade 3 in 20 patients and grade 4 in 3 patients. After one week, in group A, cell counts were grade 0 in 27 patients, grade 1 in 100 patients, grade 2 in 2 patients and grade 4 in 1 patient. While in group B, A/C cell counts were Grade 0 in 23 patients, grade 1 in 102 patients, grade 2 in 3 patients and grade 3 in 2 patients. After 6 weeks no patient in any group showed any activity in the anterior chamber.

Conclusion: There is little difference in efficacy of intracameral ceftazidime antibiotic prophylaxis as compared to the intracameral cefuroxime.

References

1. Barry P, Gardner S, Seal D, Gettinby G, Lees F, Peterson M et al. Clinical observations associated with proven and unproven cases in the ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery. Journal of Cataract & Refractive Surgery. 2009; 35(9):1523-1531.e1.

2. Clark A, Ng J, Morlet N, Tropiano E, Mahendran P, Spilsbury K et al. Quality of life after postoperative endophthalmitis. Clinical & Experimental Ophthalmology. 2008; 36(6):526-531.

3. Wejde G, Samolov B, Seregard S, Koranyi G, Montan P. Risk factors for endophthalmitis following cataract surgery: a retrospective case–control study. Journal of Hospital Infection. 2005; 61(3):251-256.

4. Ciulla TA, Starr MB, Masket S. Bacterial endophthalmitis prophylaxis for cataract surgery: an evidence-based update. Ophthalmology. 2002; 109(1):13–24.

5. Sobaci G, Tuncer K, Ta? A, Özyurt M, Bayer A, Kutlu U. The effect of intraoperative antibiotics in irrigating solutions on aqueous humor contamination and endophthalmitis after phacoemulsification surgery. Eur J Ophthalmol. 2003; 13(9–10):773–778.

6. Patrick Yu-Wai-Man, Stephen J. Morgan, Anthony J. Hildreth, David H. Steel, David Allen, Efficacy of intracameral and subconjunctival cefuroxime in preventing endophthalmitis after cataract surgery, Journal of Cataract & Refractive Surgery 2008; 34 (3): 447-451.

7. Romero P, Méndez I, Salvat M, Fernández J, Almena M. Intracameral cefazolin as prophylaxis against endophthalmitis in cataract surgery. J Cataract Refract Surg. 2006; 32(3):438–441.
8. García-Sáenz MC, Arias-Puente A, Rodrígeuz-Caravaca G, Bañuelos JB. Effectiveness of intracameral cefuroxime in preventing endophthalmitis after cataract surgery: ten-year comparative study. J Cataract Refract Surg. 2010; 36(2):203–207.

9. Lam PT, Young AL, Cheng LL, Tam PM, Lee VY.Randomized controlled trial on the safety of intracameral cephalosporins in cataract surgery. Clin Ophthalmol. 2010; 4: 1499–1504

10. Montan PG, Wejde G, Koranyi G, Rylander M. Prophylactic intracameral cefuroxime. Efficacy in preventing endophthalmitis after cataract surgery. J Cataract Refract Surg. 2002; 28(6):977–981.

11. Trusko B1, Thorne J, Jabs D, Belfort R, Dick A, Gangaputra S, Nussenblatt R, Okada A, Rosenbaum J; The Standardization of Uveitis Nomenclature (SUN) Project. Development of a clinical evidence base utilizing informatics tools and techniques. Methods Inf Med. 2013; 52(3):259-265

12. George NK, Stewart MW. The Routine Use of Intracameral Antibiotics to Prevent Endophthalmitis after Cataract Surgery: How Good is the Evidence? Ophthalmol Ther. 2018 Dec; 7(2):233-245.

13. Lockington D, Flowers H, Young D, Yorston D. Assessing the accuracy of intracameral antibiotic preparation for use in cataract surgery. J Cataract Refract Surg. 2010; 36(2):286–289.

14. Gupta MS, McKee HDR, Saldaña M, Stewart OG. Macular thickness after cataract surgery with intracameral cefuroxime. J Cataract Refract Surg. 2005; 31(6):1163–1166

15. Barry P, Behrens-Baumann W, Pleyer U, Seal D. ESCRS Guidelines on prevention, investigation and management of post-operative endophthalmitis. European Society for Cataract & Refractive Surgeons. 2007; 2

16. Endophthalmitis Study Group, European Society of Cataract and Refractive Surgeons Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg. 2007; 33(6):978–988.

17. Bowen RC, Zhou AX, Bondalapati S, Lawyer TW, Snow KB, Evans PR, Bardsley T, McFarland M, Kliethermes M, Shi D, Mamalis CA, Greene T, Rudnisky CJ, Ambati BK. Comparative analysis of the safety and efficacy of intracameral cefuroxime, moxifloxacin and vancomycin at the end of cataract surgery: a meta-analysis.Br J Ophthalmol. 2018 Sep; 102(9):1268-1276.

18. García-Sáenz MC, Arias-Puente A, Rodríguez-Caravaca G, Bañuelos JB. Effectiveness of intracameral cefuroxime in preventing endophthalmitis after cataract surgery: Ten-year comparative study. Journal of Cataract & Refractive Surgery, 2010; 36 (2): 203-7.

19. Montan PG, Wejde G, Koranyi G, Rylander M. Prophylactic intracameral cefuroxime: Efficacy in preventing endophthalmitis after cataract surgery. Journal of Cataract & Refractive Surgery,2002;28 (6): 977-81.

20. Seal DV, Barry P, Gettinby G, Lees F, Peterson M, Revie CW, Wilhelmus KR. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: Case for a European multi-centre study. J Cataract Refract Surg. 2006; 32: 396-406.

21. Röck T, Bramkamp M, Bartz-Schmidt KU, Mutlu U, Yörük E, Röck D, Thaler S. Using intracameral cefuroxime reduces postoperative endophthalmitis rate: 5 year experience at the University Eye Hospital Tübingen. Klin Monbl Augenheilkd. 2014 Oct; 231(10):1023-1028.

22. Linertová R, Abreu-González R, García-Pérez L, Alonso-Plasencia M, Cordovés-Dorta LM, Abreu-Reyes JA, Serrano-Aguilar P. Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness. Clin Ophthalmol. 2014 Aug 14;8:1515-22. doi: 10.2147/OPTH.S59776.

Published

22-12-2019

How to Cite

1.
Amjad A, Moin M. Comparison between intracameral ceftazidime & cefuroxime for the prevention of post-operative endophthalmitis. pak J Ophthalmol [Internet]. 2019 Dec. 22 [cited 2024 Mar. 5];34(2). Available from: https://pjo.org.pk/index.php/pjo/article/view/907

Issue

Section

Original Articles