Rational Drug Use in Extraocular Surgeries

Extraocular surgeries include a broad spectrum of procedures such as pterygium excision, removal of conjunctival tumors, and orbital exenteration. The objective of these surgeries is to address various ocular conditions, enhance visual function, and rectify cosmetic concerns. Nonetheless, as with any invasive procedure, these surgeries carry a risk of infection. To curtail this risk, prophylactic antibiotics are commonly used after extraocular surgeries. Administered via topical, oral, or intravenous routes, these antibiotics aim to prevent potential postoperative bacterial infections. The selection of these antibiotics is guided by their efficacy against prevalent pathogens associated with ocular infections, including Staphylococcus epidermidis and Pseudomonas aeruginosa. The choice of antibiotic, its route of administration, and duration of therapy can vary depending on the specifics of the surgery and individual patient risk factors. Moreover, in the context of extraocular surgeries, specific agents such as mitomycin C (MMC), interferon (IFN) alpha-2b, and 5-fluorouracil serve unique roles extending beyond infection prevention. MMC, an antitumor agent, aids in averting scarring and fibrosis in procedures like pterygium and glaucoma surgeries. IFN alpha-2b, with its antiviral and antiproliferative properties, is utilized to decrease the recurrence of conjunctival and corneal neoplasias postoperatively. This review examines the current understanding of prophylactic antibiotic use in certain extraocular surgeries and the role of antibiotics and some specific agents in enhancing surgical outcomes.