Antibiotic prophylaxis for cataract surgery - Practice patterns amongst Indian Ophthalmologists

Area of Science:

• Ophthalmology
• Surgical Infection Prevention
• Pharmacology

Background:

• Cataract surgery is a common procedure globally.
• Perioperative antibiotic prophylaxis is crucial to prevent post-surgical infections.
• Intracameral antibiotics (ICAB) offer targeted prophylaxis directly into the eye.

Purpose of the Study:

• To evaluate the current adoption and trends of perioperative antibiotic prophylaxis, specifically ICAB, in India.
• To identify the preferred antibiotic agents and reasons for ICAB use or non-use among Indian surgeons.

Main Methods:

• An online survey was distributed to members of the All India Ophthalmological Society (AIOS) in August 2022.
• A validated 40-point questionnaire assessed current practices regarding perioperative antibiotic prophylaxis.
• Data from 1804 respondents were analyzed to determine trends and influencing factors.

Main Results:

• 58% of respondents reported routine use of ICAB for cataract surgery, an increase from previous years.
• Moxifloxacin was the most commonly used ICAB agent (67%).
• Surgeons with more experience and those in medical colleges used ICAB less frequently; lack of perceived need was the primary reason for non-adoption.

Conclusions:

• The use of ICAB for cataract surgery in India has significantly risen, reaching 58% in 2022.
• While moxifloxacin is widely preferred, occasional toxic reactions and intraocular inflammation highlight the need for safer formulations.
• Further research into optimal ICAB strategies and formulations is warranted.