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First do no harm: routine use of aminoglycosides in the operating room

L May1, V B Navarro, J D Gottsch

  • 1Johns Hopkins Hospital, Baltimore, Md., USA.

Insight (American Society of Ophthalmic Registered Nurses)
|March 23, 2002
PubMed

Insights

Aminoglycosides, commonly used in eye surgery, pose a significant risk of toxic retinal damage, even at low doses. Recent studies suggest their intraoperative use is not justified by the potential benefits, outweighing the risk of injury.

Area of Science:

  • Ophthalmology
  • Retinal Toxicology
  • Surgical Infection Prophylaxis

Background:

  • Aminoglycosides have been standard for preventing and treating endophthalmitis in intraocular surgery for many years.
  • Emerging evidence questions the safety and efficacy of their routine use.

Purpose of the Study:

  • To review recent studies on the toxic effects of aminoglycosides on the retina.
  • To evaluate the risk-benefit ratio of intraoperative aminoglycoside use in ophthalmic procedures.

Main Methods:

  • Systematic review of recent scientific literature.
  • Analysis of studies investigating aminoglycoside-induced retinal toxicity.
  • Evaluation of clinical recommendations regarding aminoglycoside usage.

Main Results:

  • Recent studies indicate that even low doses of aminoglycosides can lead to toxic retinal damage.
  • The prophylactic or therapeutic benefits may be outweighed by the risk of ocular injury.

Conclusions:

  • The routine intraoperative use of aminoglycosides in ophthalmic surgery is not recommended due to significant risks of retinal toxicity.
  • Recommendations from institutions like Johns Hopkins Hospital, Wilmer Eye Institute support limiting or discontinuing their use.

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