Related Experiment Video
Updated: Aug 27, 2026
Intracameral Injection in Rats with Low Risk of Adverse Effects
Published on: May 31, 2024
Antibiotic injection in cataract surgery and risk of endophthalmitis: Bayesian meta-analysis
Marcelo Ramos1, Lucas M Barbosa, Sofia de Melo Ramos
1From the Advanced Ophthalmology Practice, Ipatinga, Minas Gerais, Brazil (M. Ramos); Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Barbosa, Costa, de Mattos); Medical Sciences University, Belo Horizonte, Minas Gerais, Brazil (S.M. Ramos, L.M. Ramos); Hospital Oftalmológico Brasília, Brasília, Distrito Federal, Brazil (Hida).
Topic:
Cataract surgery is the most performed surgical procedure worldwide, with more than 28 million cases annually. Traditional postoperative care relies on topical eyedrops for infection prevention and inflammation control; however, challenges such as patient noncompliance and cost limitations persist. The dropless cataract surgery approach, involving intracameral or subconjunctival administration of antibiotics and corticosteroids during surgery, has gained attention as an alternative to improve adherence, simplify care, and potentially reduce postoperative complications, including endophthalmitis.
Clinical Relevance:
To evaluate the risk of postoperative endophthalmitis associated with antibiotic injection during cataract surgery in comparison with the standard eye drop regimen.
Methods:
We systematically searched PubMed, Embase, and the Cochrane Library for studies evaluating the safety of antibiotic injections in cataract surgery compared with conventional postoperative regimens. Bayesian random-effects meta-analysis was used for marginal posterior distributions for the overall and between-study heterogeneity, expressed as odds ratios (ORs) with 95% credible intervals (CrIs). Risk of bias was assessed with Risk of Bias in Nonrandomized Studies-of Interventions or Risk of Bias Tool for Assessing Bias in Randomized Controlled Trials. All statistical analyses were performed using R v. 4.5.0.
Results:
54 studies were included, encompassing 6 867 422 surgeries of which 3 501 802 received antibiotic injection therapy. Antibiotic injection was associated with a reduction in the risk of postoperative endophthalmitis (OR 0.208; 95% CrI: 0.161-0.268), with a 100% posterior probability of clinically meaningful benefit (OR <0.80) and a 99.1% likelihood that future studies would confirm these findings. Sensitivity analyses corroborated the general findings.
Conclusions:
The use of antibiotic injection was associated with a significant reduction in the risk of postoperative endophthalmitis.
