Use of Intracameral Antibiotics Prophylaxis in Patients with Posterior Capsular Rupture during Cataract Surgery: a Systematic Review and Meta-analysis
Abstract
TOPIC
Posterior capsular rupture (PCR) during cataract surgery predisposes patients to postoperative endophthalmitis (POE). However, little is known about the prophylactic use of intracameral antibiotics (ICA) to prevent POE after PCR. Therefore, we conducted this systematic review and meta-analysis to assess the efficacy of ICA in preventing POE in patients with PCR.
CLINICAL RELEVANCE
PCR increases the risk of POE by over 6-fold, emphasizing the need for targeted prophylactic strategies. This study focuses on the clinical importance of ICA in reducing the incidence of POE in this high-risk population.
METHODS
We searched PubMed, Embase and Cochrane for articles published up to May 21th, 2024, with the following strategy: (cataract OR phaco OR "Cataract Extraction" OR "manual small incision cataract surgery" OR phacoemulsification OR "extracapsular cataract extraction" OR ECCE) AND (intracameral OR "Intracameral Injection" OR "irrigating infusion fluid" OR "anterior chamber injection") AND (antibiotic OR moxifloxacin OR cefuroxime OR vancomycin OR cephalosporin OR prophylaxis). We included studies reporting the incidence of endophthalmitis in patients with PCR during cataract surgery and a comparison of prophylactic intracameral antibiotics with no intracameral antibiotics. Statistical analysis was conducted using R software version 4.3.2. The protocol was registered in PROSPERO (CRD42024558144).
RESULTS
The initial search yielded 1,660 results. After removing duplicate…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 153,690 participants or records.
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