在印度重新评估前房注射头孢呋辛作为白内障手术后眼内炎预防措施的效果。

Reevaluating intracameral cefuroxime as a prophylaxis against endophthalmitis after cataract surgery in India.

作者信息

Sharma Savitri, Sahu Srikant K, Dhillon Vivek, Das Sujata, Rath Suryasnata

机构信息

From the L.V. Prasad Eye Institute, Odisha, India.

出版信息

J Cataract Refract Surg. 2015 Feb;41(2):393-9. doi: 10.1016/j.jcrs.2014.05.038. Epub 2014 Dec 20.

DOI:10.1016/j.jcrs.2014.05.038

PMID:25535109

Abstract

PURPOSE

To determine whether an intracameral injection of cefuroxime sodium at the conclusion of cataract surgery lowers the incidence of acute-onset postoperative endophthalmitis.

SETTING

Tertiary eye care center, Bhubaneswar, India.

DESIGN

Prospective comparative interventional cohort study.

METHODS

Under a uniform protocol, cataract surgery with posterior chamber intraocular lens (PC IOL) implantation was performed from September 27, 2006, to July 31, 2010 (Group 1). All eyes were evaluated 1 day, 7 days, and 5 weeks ± 1 (SD) postoperatively. Treatment of eyes suspected to have developed infectious endophthalmitis was managed by retina-vitreous surgeons. From August 1, 2010, to August 31, 2012, the same surgeons performed cataract surgery with PC IOL implantation in another group of eyes, in which they administered intracameral cefuroxime prophylaxis (Group 2). All other protocols of postoperative care and microbiological investigation of the vitreous samples were similar. The rate of clinical and culture-positive endophthalmitis was compared between the 2 study groups: eyes without intracameral cefuroxime (Group 1) and eyes with intracameral cefuroxime (Group 2).

RESULTS

The incidence of clinical endophthalmitis in Group 1 (0.155% [12/7756 eyes]) and in Group 2 (0.108% [8/7366 eyes]) was not significantly different (P = .57). The culture positivity rate in Group 1 (0.09 % [7 eyes]) and in Group 2 (0.04% [3 eyes]) was also not significantly different (P = .38). In the treatment without intracameral cefuroxime, there was a minimal, statistically insignificant increase in postoperative acute endophthalmitis (odds ratio, 1.42; 95% confidence interval, 0.53-4.02; P = .506).

CONCLUSION

There is not strong evidence to support use of intracameral cefuroxime to reduce the rate of acute endophthalmitis after cataract surgery; however, the marginal benefit might justify its use.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

确定白内障手术结束时前房注射头孢呋辛钠是否能降低急性术后眼内炎的发生率。

设置

印度布巴内斯瓦尔的三级眼科护理中心。

设计

前瞻性比较干预队列研究。

方法

按照统一方案，于2006年9月27日至2010年7月31日进行白内障手术并植入后房型人工晶状体（PC IOL）（第1组）。所有术眼在术后1天、7天和5周±1（标准差）进行评估。疑似发生感染性眼内炎的术眼由视网膜玻璃体外科医生进行处理。从2010年8月1日至2012年8月31日，同一批外科医生在另一组术眼中进行白内障手术并植入PC IOL，术中给予前房注射头孢呋辛预防（第2组）。术后护理和玻璃体样本微生物学检查的所有其他方案均相似。比较两个研究组（未进行前房注射头孢呋辛的术眼（第1组）和进行前房注射头孢呋辛的术眼（第2组））临床及培养阳性眼内炎的发生率。

结果

第1组（0.155%[12/7756只眼]）和第2组（0.108%[8/7366只眼]）临床眼内炎的发生率无显著差异（P = 0.57）。第1组（0.09%[7只眼]）和第2组（0.04%[3只眼]）的培养阳性率也无显著差异（P = 0.38）。在未进行前房注射头孢呋辛的治疗中，术后急性眼内炎有极小的、无统计学意义的增加（优势比，1.42；95%置信区间，0.53 - 4.02；P = 0.506）。