• Written By: Adam J. Gess, MD
    Cataract/Anterior Segment

    This prospective study found that topical neomycin/polymyxin-B is equally effective whether given 1 hour or 1 day before surgery, suggesting physicians can choose a cheaper, easier regimen without increasing the risk for postoperative endophthalmitis.

    Subjects included 133 consecutive patients randomized across the 2 regimens. In both groups, the conjunctival sac was irrigated with 10.0 mL of povidone-iodine 1.0% solution.

    The antibiotic regimens were equally effective at reducing the aerobic and microaerophilic conjunctival flora but had no significant effect on anaerobic bacteria.

    Flush irrigation of the conjunctival sac using povidone–iodine significantly decreased the conjunctival bacterial load in both groups.

    Despite all prophylactic measures, they found  residual contamination remained on the ocular surface at the end of surgery, at a rate of about  8% in each group. Therefore, they say that intracameral injection of antibiotics at the end of surgery may be useful in cases with a higher risk for intraoperative infection, such as those with a posterior capsule rupture or surgery significantly longer than average duration.