Endophthalmitis prevention in Refractive Lens Exchange

The aim of this study was to evaluate the safety and efficacy of the intracameral antibiotics vancomycin, cefuroxime, and moxifloxacin, as well as the need for topical antibiotics preoperatively, postoperatively, or both. A systematic review and meta-analysis were conducted using PubMed to compare their efficacy in cataract surgery performed by phacoemulsification. We also assessed the additional benefit of topical antibiotics in preventing endophthalmitis when intracameral antibiotics and povidone-iodine were used. All included studies supported the use of intracameral antibiotics at the end of surgery. The results were more favourable for moxifloxacin and vancomycin than for cefuroxime, although no statistically significant differences were found. In addition, the secondary analysis showed no additional benefit from the perioperative use of topical antibiotics. Intracameral antibiotic injection is a safe and effective measure for the prevention of endophthalmitis following phacoemulsification. The use of vancomycin remains controversial. Furthermore, postoperative topical antibiotics do not appear to provide any additional benefit when intracameral antibiotics are administered.