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P. Yu-Wai-Man, S. J. Morgan, A. J. Hildreth, D. H. Steel, D. Allen; Is Intracameral Cefuroxime Better Than Subconjunctival Cefuroxime in Preventing Endophthalmitis?. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2873.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the efficacy of intracameral cefuroxime versus subconjunctivalcefuroxime in reducing the rate of endophthalmitis followingcataract surgery
A retrospective analysis was performed of all presumed infectiousendophthalmitis (PIE) cases from January 1, 2000 to December31, 2006, at Sunderland Eye Infirmary, a single specialty eyeunit. From January 1, 2000 to November 16, 2003, all patientsreceived a subconjunctival injection of cefuroxime at the endof the procedure. A change of practice occurred on November17, 2003 and all patients were instead given an intracameralinjection of cefuroxime. The rate of PIE between these two groupswas compared using Chi-squared test with Yates correction forcategorical data (Table 1).
36,743 phacoemulsification procedures were included in thisstudy and the average rate of PIE was 0.95 per 1,000 cases from2000 to 2006 (Figure 1). The incidence of endophthalmitis washigher in the group receiving subconjunctival cefuroxime comparedto the intracameral route and this difference was statisticallysignificant with an odds ratio of 3.01 (95% CI 1.37 to 6.63).
Our study is the first to directly compare the efficacy of intracameraland subconjunctival cefuroxime in the prophylaxis of post-operativeendophthalmitis. Although confirmatory studies are needed, ourresults indicate that the intracameral route is a safe alternativeto subconjunctival delivery of cefuroxime and leads to a lowerrate of endophthalmitis.
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