1
|
Kelkar AS, Sharma N, Verma L, Chandorkar SA, Saxena R, Mishra D, Kelkar JA, Sengupta S. Antibiotic prophylaxis for cataract surgery - Practice patterns amongst Indian Ophthalmologists. Indian J Ophthalmol 2023; 71:3235-3241. [PMID: 37602614 PMCID: PMC10565941 DOI: 10.4103/ijo.ijo_702_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose To assess the current trends in use of perioperative antibiotic prophylaxis, especially intracameral antibiotics (ICAB), for cataract surgery in India. Methods This was an E-survey using a previously validated questionnaire carried out by the All India Ophthalmological Society (AIOS) in August 2022. An E-mail invitation to complete an online 40-point survey was sent to all members of the AIOS using a digital E-mail service (Survey Monkey) and social media platforms. Results Out of 1804 total respondents, 58% (n = 1022) reported using routine ICAB prophylaxis. Of those using ICAB, 89% (n = 909) reported using it for all cases, whereas the rest used it for specific indications such as post-PC rent (n = 43), one eyed patient (n = 19), and high-risk cases (n = 50). Commercially available moxifloxacin was by far the commonest agent used for ICAB (n = 686, 67%). Eighty respondents (8%) reported noticing occasional toxic reactions and nontoxic corneal edema (n = 64, 6%) with ICAB. Surgeons with >10 years' experience especially practicing in medical colleges used fewer ICAB (OR = 0.52, 95%CI = 0.38 - 0.72, P < 0,001) compared to younger surgeons (<5-year experience) in solo clinics. The commonest reason for nonadoption of IC antibiotics was "unconvinced of the need to use it in my setting" (n = 296, 52% of those who answered this question). Conclusion IC antibiotic prophylaxis for cataract surgery has significantly increased in India from 40% in 2017 to 58% in 2022. Commercially available moxifloxacin was preferred by the majority users. Intraocular inflammation may occur occasionally and needs safer formulations to avoid this.
Collapse
Affiliation(s)
- Aditya S Kelkar
- Department of Ophthalmology, National Institute of Ophthalmology, (NIO) Pune, Maharashtra, India
| | - Namrata Sharma
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | | | - Shraddha A Chandorkar
- Vitreo-Retinal Services, National Institute of Ophthalmology, Pune, Maharashtra, India
| | - Rohit Saxena
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Mishra
- Department of Ophthalmology, Regional Institute of Ophthalmology, IMS, BHU, Varanasi, UP, India
| | - Jai A Kelkar
- Department of Ophthalmology, National Institute of Ophthalmology, Pune, Maharashtra, India
| | - Sabhyasachi Sengupta
- Department of Ophthalmology, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
| |
Collapse
|
2
|
Kato A, Horita N, Namkoong H, Nomura E, Masuhara N, Kaneko T, Mizuki N, Takeuchi M. Prophylactic antibiotics for postcataract surgery endophthalmitis: a systematic review and network meta-analysis of 6.8 million eyes. Sci Rep 2022; 12:17416. [PMID: 36258003 PMCID: PMC9579149 DOI: 10.1038/s41598-022-21423-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/27/2022] [Indexed: 01/12/2023] Open
Abstract
To reveal optimal antibiotic prophylactic regimen for postoperative endophthalmitis (POE), we conducted systematic review and network meta-analysis. A total of 51 eligible original articles, including two randomized controlled trials, were identified. In total, 4502 POE cases occurred in 6,809,732 eyes (0.066%). Intracameral injection of vancomycin had the best preventive effect (odds ratio [OR] 0.03, 99.6% confidence interval [CI] 0.00-0.53, corrected P-value = 0.006, P-score = 0.945) followed by intracameral injection of cefazoline (OR 0.09, 99.6% CI 0.02-0.42, corrected P-value < 0.001, P-score = 0.821), cefuroxime (OR 0.18, 99.6% CI 0.09-0.35, corrected P-value < 0.001, P-score = 0.660), and moxifloxacin (OR 0.36, 99.6% CI 0.16-0.79, corrected P-value = 0.003, P-score = 0.455). While one randomized controlled trial supported each of intracameral cefuroxime and moxifloxacin, no randomized controlled trial evaluated vancomycin and cefazoline. Sensitivity analysis focusing on the administration route revealed that only intracameral injection (OR 0.19, 99.4% CI 0.12-0.30, corrected P-value < 0.001, P-score = 0.726) significantly decreased the risk of postoperative endophthalmitis. In conclusion, intracameral injection of either vancomycin, cefazoline, cefuroxime, or moxifloxacin prevented POE.
Collapse
Affiliation(s)
- Ai Kato
- grid.268441.d0000 0001 1033 6139Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan ,Department of Ophthalmology, Chigasaki Municipal Hospital, Chigasaki, Kanagawa Japan
| | - Nobuyuki Horita
- grid.470126.60000 0004 1767 0473Chemotherapy Center, Yokohama City University Hospital, Yokohama, Kanagawa Japan
| | - Ho Namkoong
- grid.26091.3c0000 0004 1936 9959Department of Infectious Diseases, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Eiichi Nomura
- grid.268441.d0000 0001 1033 6139Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
| | - Nami Masuhara
- Department of Ophthalmology, Chigasaki Municipal Hospital, Chigasaki, Kanagawa Japan
| | - Takeshi Kaneko
- grid.268441.d0000 0001 1033 6139Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa Japan
| | - Nobuhisa Mizuki
- grid.268441.d0000 0001 1033 6139Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
| | - Masaki Takeuchi
- grid.268441.d0000 0001 1033 6139Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
| |
Collapse
|
3
|
Verma L, Agarwal A, Dave VP, Honavar SG, Majji AB, Lall A, Mahobia A, Grover AK, Gupta A, Shroff C, Talwar D, Ravindra MS, Goyal M, Sharma N, Kamdar PA, Bhende P, Samant P, Rishi P, Ravindran RD, Narayanan R, Sinha R, Pappuru RR, Kumar SS, Saravanan VR, Lahane TP, Gajiwala U, Pradeep V. All India Ophthalmological Society (AIOS) Task Force guidelines to prevent intraocular infections and cluster outbreaks after cataract surgery. Indian J Ophthalmol 2022; 70:362-368. [PMID: 35086198 PMCID: PMC9023903 DOI: 10.4103/ijo.ijo_94_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Infectious endophthalmitis is a serious and vision-threatening complication of commonly performed intraocular surgeries such as cataract surgery. The occurrence of endophthalmitis can result in severe damage to the uveal and other ocular tissues even among patients undergoing an uncomplicated surgical procedure. If the infections result from common factors such as surgical supplies, operative or operation theater-related risks, there can be a cluster outbreak of toxic anterior segment syndrome (TASS) or infectious endophthalmitis, leading to several patients having an undesirable outcome. Since prevention of intraocular infections is of paramount importance to ophthalmic surgeons, the All India Ophthalmological Society (AIOS) has taken the lead in the formation of a National Task Force to help ophthalmic surgeons apply certain universal precautions in their clinical practice. The Task Force has prepared a handy checklist and evidence-based guidelines to minimize the risk of infectious endophthalmitis following cataract surgery.
Collapse
Affiliation(s)
| | - Aniruddha Agarwal
- Department of Ophthalmology, Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Vivek Pravin Dave
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, Kallam Anji Reddy Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | | | | | | | | | | | | | | | | | - M S Ravindra
- Karthik Netralaya Eye Hospital, Bengaluru, Karnataka, India
| | - Mallika Goyal
- Department of Ophthalmology, Apollo Eye Hospital, Apollo Health City, Hyderabad, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | | | - Pramod Bhende
- Director, Sri Bhagwan Mahavir Department of Vitreoretinal Surgery, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Preetam Samant
- P. D. Hinduja Hospital, Mahim, Mumbai, Maharashtra, India
| | - Pukhraj Rishi
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - R D Ravindran
- Department of Ophthalmology, Aravind Eye Hospital, Chennai, Tamil Nadu, India
| | - Raja Narayanan
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, Kallam Anji Reddy Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Rajesh Sinha
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rajiv Reddy Pappuru
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, Kallam Anji Reddy Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | | | - V R Saravanan
- Department of Ophthalmology, Aravind Eye Hospital, Chennai, Tamil Nadu, India
| | - Tatyarao P Lahane
- Department of Ophthalmology, Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Uday Gajiwala
- Divyajyoti trust, Mandvi, Dist. Surat, Gujarat, India
| | - Venkatesh Pradeep
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
4
|
Tabl A, Masoud M, Abdelhalim G, Tabl M. Outcomes of early vitrectomy for endophthalmitis after cataract surgery in delta population, Egypt, 2015–2020. JOURNAL OF THE EGYPTIAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.4103/ejos.ejos_14_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
5
|
Shenoy P, Mehta S, Shah C, Joshi R, Sen P, Patidar N, Kohli GM, Sen A. Comparison of post-cataract surgery endophthalmitis rates using syringing or regurgitation on pressure over the lacrimal sac as a preoperative screening tool for nasolacrimal duct obstruction: An impact assessment of protocol alteration due to the COVID-19 pandemic. Indian J Ophthalmol 2021; 69:2824-2827. [PMID: 34571642 PMCID: PMC8597482 DOI: 10.4103/ijo.ijo_1218_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To compare the post-cataract endophthalmitis (PCE) rates among eyes undergoing syringing or regurgitation on pressure over the lacrimal sac (ROPLAS) test prior to cataract surgery. Methods We performed a single-center, retrospective, comparative analysis of eyes developing PCE who underwent syringing prior to cataract surgery (group A) in the pre-COVID-19 era between November 1 2019 and January 31, 2020 and the eyes that underwent ROPLAS test prior to cataract surgery (group B) in the COVID-19 era between November 1, 2020 and January 31, 2021. Results A total of 87,144 eyes underwent cataract surgery during the two time periods of the study. Syringing was performed in 48,071 eyes, whereas ROPLAS was performed in 39,073 eyes. In group A, 19 eyes (0.039%) developed PCE, whereas 20 eyes (0.051%) developed PCE in group B (P = 0.517). Between the two groups, the grade of anterior chamber cellular reaction (P = 0.675), hypopyon (P = 0.738), and vitreous haze (P = 0.664) were comparable. Gram-positive organisms were detected in 4 eyes in group A and 6 eyes in group B; 2 eyes in group A had gram-negative bacilli. The presenting visual acuity (Group A: LogMAR 1.42 and Group B: LogMAR 1.30) and final visual acuity (Group A: LogMAR 0.52 and Group B: LogMAR 0.5) were comparable between the two groups. (P = 0.544 and 0.384, respectively). Conclusion The rates of PCE were comparable among the eyes undergoing either syringing test or ROPLAS prior to cataract surgery.
Collapse
Affiliation(s)
- Pratik Shenoy
- Department of Vitreo-Retina and Uvea, Sadguru Netra Chikistalaya, Chitrakoot, Madhya Pradesh, India
| | - Sonali Mehta
- Department of DNB Resident, Sadguru Netra Chikistalaya, Chitrakoot, Madhya Pradesh, India
| | - Chintan Shah
- Department of Pediatric Ophthalmology and Strabsimus, Sadguru Netra Chikistalaya, Chitrakoot, Madhya Pradesh, India
| | - Rajesh Joshi
- Department of Cataract and IOL, Sadguru Netra Chikistalaya, Chitrakoot, Madhya Pradesh, India
| | - Pradhnya Sen
- Department of Pediatric Ophthalmology and Strabsimus, Sadguru Netra Chikistalaya, Chitrakoot, Madhya Pradesh, India
| | - Narendra Patidar
- Department of Orbit and Oculoplasty, Sadguru Netra Chikistalaya, Chitrakoot, Madhya Pradesh, India
| | - Gaurav Mohan Kohli
- Department of Vitreo-Retina and Uvea, Sadguru Netra Chikistalaya, Chitrakoot, Madhya Pradesh, India
| | - Alok Sen
- Department of Vitreo-Retina and Uvea, Sadguru Netra Chikistalaya, Chitrakoot, Madhya Pradesh, India
| |
Collapse
|