亚太眼科教授学会（AAPPO）、亚太玻璃体视网膜学会（APVRS）、亚太眼部炎症与感染学会（APSOII）《白内障术后急性发性细菌性眼内炎的预防、诊断和管理争议、共识和指南》

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-08-16 DOI:10.1016/j.ajo.2025.08.031

Namrata Sharma , Aafreen Bari , Srinivas K. Rao , Rupesh Agrawal , Penelope J. Allen , John C. Buchan , Andrew Chang , David F. Chang , Soon-Phaik Chee , Weirong Chen , Kuan-Jen Chen , Vanissa W.S. Chow , Taraprasad Das , Vivek P. Dave , Harry W. Flynn JR , Tina Felfeli , Adrian T. Fung , Andrzej Grzybowski , Mary Ho , Wai Ching Lam , Dennis S.C. Lam

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引用次数: 0

摘要

白内障手术后眼内炎是一种严重但在很大程度上可以预防的临床疾病。实施统一的术前、术中、术后方案对于减少其发生率至关重要。鉴于新出现的证据和临床实践中的相当大的差异，由亚太眼科教授学会（AAPPO）、亚太玻璃体视网膜学会（APVRS）和亚太眼部炎症和感染学会（APSOII）组成的国际专家小组召开会议，制定针对白内障手术所有阶段的循证指南。这份共识手稿是对当前文献进行系统回顾的产物，由小组成员的集体经验和专业知识提供信息。该小组进行了结构化的讨论，对临床数据进行了批判性评估，并正式投票确定了三个关键领域的协议：(1)术前和术中预防策略，(2)术后早期急性细菌性眼内炎的诊断方法，以及(3)标准化的管理方案。对每个提议的声明进行投票使用李克特五点量表（强烈同意，同意，中立，不同意，强烈不同意）。共识被定义为≥75%的专家投票“强烈同意”或“同意”。共评价了45份共识陈述，其中21份（46.6%）达到了预定的共识水平。本文旨在建立标准化的指导方针，通过降低术后眼内炎的风险来提高白内障手术的效果。对于尚未达成共识的领域，专家组建议进一步调查和继续研究，以指导临床实践的未来更新。

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Controversies, Consensuses, and Guidelines on Preventing, Diagnosing and Managing Acute-onset Bacterial Endophthalmitis after Cataract Surgery by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-retina Society (APVRS), and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII)

Background

Postcataract surgery endophthalmitis is a serious but largely preventable clinical entity. The implementation of uniform preoperative, intraoperative, and postoperative protocols is essential to reduce its incidence.

Methods

In light of emerging evidence and considerable variability in clinical practices, a panel of international experts from the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-retina Society (APVRS), and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII) convened to develop evidence-based guidelines addressing all phases of cataract surgery. This consensus manuscript is the product of a systematic review of the current literature, informed by the collective experience and expertise of the panel members. The panel engaged in structured discussions, critical evaluation of clinical data, and formal voting to establish agreement across three key domains: (1) preoperative and intraoperative prophylactic strategies, (2) diagnostic approaches for early postoperative acute bacterial endophthalmitis, and (3) standardized management protocols. Voting on each proposed statement was conducted using a 5-point Likert scale (strongly agree, agree, neutral, disagree, strongly disagree). Consensus was defined as ≥75% of experts voting either “strongly agree” or “agree.”

Results

A total of 45 consensus statements were evaluated, of which 21 (46.6%) achieved the predefined level of consensus.

Conclusions

This document aims to establish standardized guidelines to improve cataract surgery outcomes by minimizing the risk of postoperative endophthalmitis. For areas where consensus was not achieved, the panel recommends further investigation and continued research to guide future updates to clinical practice.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.