Local antimicrobial prophylaxis in cataract surgery: recent controversies and clinical guidelines

The best prevention of endophthamitis is the use of strict surgical hygiene. Supplementing the irrigating solution with aminoglycosides and/or vancomycin is a rational, convenient and cost effective method of antimicrobial prophylaxis. However emerging resistance to vancomycin entails restrictions to its daily use. In conclusion, two options are possible: limit the use of prophylaxis in the irrigating solution to only those patients at high risk of injection, or use topical and general antibioprophylaxis with low cost drugs.