Effectiveness of intracameral cefuroxime in preventing endophthalmitis after cataract surgery Ten-year comparative study

PURPOSE: to determine the differences in the endophthalmitis rates in cataract surgery before and after prophylactic use of intracameral cefuroxime. SETTING: University Hospital Fundacion Alcorcon, Madrid, Spain. METHODS: this prospective study evaluated patients who had cataract surgery at a university eye center over a 10-year period (1999 to 2008). Since the protocol's approval by the Hospital Board in October 2005 to the end of the 10-year period, cataract patients were routinely treated with prophylactic intracameral cefuroxime. A database was used to measure the occurrence of endophthalmitis postoperatively. Then, the incidence of endophthalmitis before and after generalized use of prophylactic cefuroxime was compared. The effect of cefuroxime was evaluated by the relative risk. RESULTS: from January 1999 to December 2008, 13 652 patients had cataract surgery. Forty-two cases of postoperative bacterial endophthalmitis were reported. The endophthalmitis rate was 0.30% (95% confidence interval [CI], 0.26%-0.35%) overall, 0.59% (95% CI, 0.50%-0.70%) from January 1999 to September 2005, and 0.043% (95% CI, 0.02%-0.06%) from October 2005 to December 2008. The relative risk was 0.07 (range 0.022 to 0.231; P<.05). CONCLUSION: intracameral cefuroxime proved to be effective in reducing the risk for acute-onset endophthalmitis after cataract surgery.