Systematic Reviews and Meta-analyses of Clinical Trials
Because they combine evidence from 2 or more clinical trials, systematic reviews and meta-analyses provide the strongest evidence for assessing interventions for a particular condition (see Fig 1-2). For example, to compare the safety and efficacy of intracameral cefuroxime, moxifloxacin, and vancomycin at the end of cataract surgery, Bowen and colleagues reviewed the results of 17 studies with over 900,000 eyes. They showed an 80% decrease (P < .001) in risk of endophthalmitis when using intracameral antibiotics. They also reported minimal toxicity for moxifloxacin; dosing errors related to toxicity for cefuroxime; and rare toxic retinal events with vancomycin use. Overall, this meta-analysis strongly supports intracameral antibiotics after cataract surgery to prevent endophthalmitis.
Bowen RC, Zhou AX, Bondalapati S, et al. Comparative analysis of the safety and efficacy of intracameral cefuroxime, moxifloxacin and vancomycin at the end of cataract surgery: a meta-analysis. Br J Ophthalmol. 2018;102(9):1268–1276.
Excerpted from BCSC 2020-2021 series: Section 1 - Update on General Medicine. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.