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Prophylaxis of Postoperative Endophthalmitis Following Cataract Surgery

Current Status and Future Directions

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Abstract

Endophthalmitis is an uncommon but potentially devastating intraocular infection that can occur after routine cataract surgery. Although a broad spectrum of organisms have been shown to cause acute postoperative endophthalmitis, most cases are caused by Gram-positive bacteria, which may be introduced at the time of surgery from colonization of adjacent conjunctiva or eyelid skin. Risk factors for the development of endophthalmitis following cataract surgery include patient age, intraoperative surgical complications and poor wound construction. There are several antibacterial strategies employed to prevent postoperative endophthalmitis, with topical, intracameral and subconjunctival delivery being the most common. Worldwide, there seems to be significant regional variance in the type and method of prophylactic antibacterial regimens; for example, topical fluoroquinolones are commonly used in the US, while intracameral cephalosporins are employed widely in Europe. The optimal antibacterial strategy for the prevention of endophthalmitis should be safe, inexpensive and broad in microbiological activity spectrum, while not requiring patient compliance for its effectiveness.

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Acknowledgements

No sources of funding were used in the preparation of this review. Neither of the authors have any financial interest in any of the products or techniques described in this review.

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Authors and Affiliations

  1. Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA

    Robert E. Fintelmann & Ayman Naseri MD

  2. Francis I. Proctor Foundation for Research in Ophthalmology, University of California San Francisco, San Francisco, California, USA

    Robert E. Fintelmann & Ayman Naseri MD

  3. Department of Ophthalmology, San Francisco Veterans Administration Medical Center, 4150 Clement St, San Francisco, California, 94121, USA

    Ayman Naseri MD

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Correspondence to Ayman Naseri MD.

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Fintelmann, R.E., Naseri, A. Prophylaxis of Postoperative Endophthalmitis Following Cataract Surgery. Drugs 70, 1395–1409 (2010). https://doi.org/10.2165/11537950-000000000-00000

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