Evaluating the efficacy of postoperative topical antibiotics in cataract surgery: A systematic review and meta-analysis.

IF 3 3区 医学 Q1 OPHTHALMOLOGY
Maria Laura Passaro, Matteo Posarelli, Fabio Claudio Avolio, Mariantonia Ferrara, Ciro Costagliola, Francesco Semeraro, Gianni Virgili, Mor M Dickman, Vito Romano
{"title":"Evaluating the efficacy of postoperative topical antibiotics in cataract surgery: A systematic review and meta-analysis.","authors":"Maria Laura Passaro, Matteo Posarelli, Fabio Claudio Avolio, Mariantonia Ferrara, Ciro Costagliola, Francesco Semeraro, Gianni Virgili, Mor M Dickman, Vito Romano","doi":"10.1111/aos.17469","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Cataract surgery is the most frequently performed surgical procedure worldwide, but postoperative endophthalmitis remains a serious complication that can lead to vision loss. While intracameral (IC) antibiotics are well established in significantly reducing the risk of postoperative infections, there is no consensus on the use of postoperative topical antibiotics. This systematic review and meta-analysis aimed to evaluate the efficacy of topical antibiotics in preventing endophthalmitis in patients already receiving IC antibiotics.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Scopus and Cochrane databases yielded 31 studies that met the inclusion criteria, involving patients who underwent cataract surgery via phacoemulsification. The patients were divided into two groups: those receiving IC antibiotics alone and those receiving additional postoperative topical antibiotics. The primary outcome was the incidence of postoperative endophthalmitis.</p><p><strong>Results: </strong>A total of 1 235 051 eyes were included in the meta-analysis, with 608 302 in the IC + T group, which received intraoperative intracameral antibiotics combined with postoperative topical antibiotics, and 626 749 in the IC group, which received intracameral antibiotics alone. The pooled analysis revealed no statistically significant difference in the incidence of endophthalmitis between the two groups (p = 0.97), with an incidence of 0.0004 (95% CI: 0.0003-0.0005) in both groups. These results suggest that the addition of topical antibiotics does not provide further benefit in preventing infections beyond IC antibiotics alone.</p><p><strong>Conclusions: </strong>IC antibiotics as a sole prophylactic measure may be sufficient, and the routine use of postoperative topical antibiotics could be unnecessary. Reducing the use of topical antibiotics may also help mitigate the risk of antimicrobial resistance.</p>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Ophthalmologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/aos.17469","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: Cataract surgery is the most frequently performed surgical procedure worldwide, but postoperative endophthalmitis remains a serious complication that can lead to vision loss. While intracameral (IC) antibiotics are well established in significantly reducing the risk of postoperative infections, there is no consensus on the use of postoperative topical antibiotics. This systematic review and meta-analysis aimed to evaluate the efficacy of topical antibiotics in preventing endophthalmitis in patients already receiving IC antibiotics.

Methods: A comprehensive search of PubMed, Scopus and Cochrane databases yielded 31 studies that met the inclusion criteria, involving patients who underwent cataract surgery via phacoemulsification. The patients were divided into two groups: those receiving IC antibiotics alone and those receiving additional postoperative topical antibiotics. The primary outcome was the incidence of postoperative endophthalmitis.

Results: A total of 1 235 051 eyes were included in the meta-analysis, with 608 302 in the IC + T group, which received intraoperative intracameral antibiotics combined with postoperative topical antibiotics, and 626 749 in the IC group, which received intracameral antibiotics alone. The pooled analysis revealed no statistically significant difference in the incidence of endophthalmitis between the two groups (p = 0.97), with an incidence of 0.0004 (95% CI: 0.0003-0.0005) in both groups. These results suggest that the addition of topical antibiotics does not provide further benefit in preventing infections beyond IC antibiotics alone.

Conclusions: IC antibiotics as a sole prophylactic measure may be sufficient, and the routine use of postoperative topical antibiotics could be unnecessary. Reducing the use of topical antibiotics may also help mitigate the risk of antimicrobial resistance.

评估白内障手术术后局部抗生素的疗效:系统回顾和荟萃分析。
目的:白内障手术是世界上最常见的外科手术,但术后眼内炎仍然是一个严重的并发症,可导致视力丧失。虽然肠腔内(IC)抗生素在显著降低术后感染风险方面得到了很好的证实,但在术后使用外用抗生素方面尚无共识。本系统综述和荟萃分析旨在评估外用抗生素预防已接受IC抗生素患者眼内炎的疗效。方法:对PubMed、Scopus和Cochrane数据库进行综合检索,获得31项符合纳入标准的研究,涉及行白内障超声乳化手术的患者。患者分为两组:单独使用IC抗生素组和术后额外使用局部抗生素组。主要观察指标是术后眼内炎的发生率。结果:meta分析共纳入1 235 051只眼,其中IC + T组608 302只眼,术中应用内窥镜抗生素联合术后外用抗生素,IC组626 749只眼,单独应用内窥镜抗生素。合并分析显示,两组眼内炎发生率无统计学差异(p = 0.97),两组发生率为0.0004 (95% CI: 0.0003-0.0005)。这些结果表明,除了单独使用IC抗生素外,添加局部抗生素并不能提供预防感染的进一步益处。结论:IC抗生素作为唯一的预防措施可能是足够的,术后常规使用局部抗生素可能是不必要的。减少局部抗生素的使用也可能有助于减轻抗菌素耐药性的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Acta Ophthalmologica
Acta Ophthalmologica 医学-眼科学
CiteScore
7.60
自引率
5.90%
发文量
433
审稿时长
6 months
期刊介绍: Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信