Marcelo Ramos, Lucas M Barbosa, Sofia de Melo Ramos, Luisa de Melo Ramos, Jhonattan Rodrigues Garcia Costa, João Vítor de Mattos, Wilson Takashi Hida
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引用次数: 0
Abstract
Topic: Cataract surgery is the most performed surgical procedure worldwide, with more than 28 million cases annually. Traditional postoperative care relies on topical eyedrops for infection prevention and inflammation control; however, challenges such as patient noncompliance and cost limitations persist. The dropless cataract surgery approach, involving intracameral or subconjunctival administration of antibiotics and corticosteroids during surgery, has gained attention as an alternative to improve adherence, simplify care, and potentially reduce postoperative complications, including endophthalmitis.
Clinical relevance: To evaluate the risk of postoperative endophthalmitis associated with antibiotic injection during cataract surgery in comparison with the standard eye drop regimen.
Methods: We systematically searched PubMed, Embase, and the Cochrane Library for studies evaluating the safety of antibiotic injections in cataract surgery compared with conventional postoperative regimens. Bayesian random-effects meta-analysis was used for marginal posterior distributions for the overall and between-study heterogeneity, expressed as odds ratios (ORs) with 95% credible intervals (CrIs). Risk of bias was assessed with Risk of Bias in Nonrandomized Studies-of Interventions or Risk of Bias Tool for Assessing Bias in Randomized Controlled Trials. All statistical analyses were performed using R v. 4.5.0.
Results: 54 studies were included, encompassing 6 867 422 surgeries of which 3 501 802 received antibiotic injection therapy. Antibiotic injection was associated with a reduction in the risk of postoperative endophthalmitis (OR 0.208; 95% CrI: 0.161-0.268), with a 100% posterior probability of clinically meaningful benefit (OR <0.80) and a 99.1% likelihood that future studies would confirm these findings. Sensitivity analyses corroborated the general findings.
Conclusions: The use of antibiotic injection was associated with a significant reduction in the risk of postoperative endophthalmitis.
期刊介绍：
The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS).
JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.
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