Europäische Perspektiven – FEOph Symposium
Das FEOph Symposium 2019 befasst sich unter dem Titel „To inject or not to inject“ mit der Frage des Pro und Contra der Antiose in der Kataraktchirurgie.
Nach Vorträgen zu diesem Themenbereich, vertiefen Experten aus dem Vereinigten Königreich, Frankreich, Italien, Spanien und Deutschland die Diskussion, stellen sowohl die in ihren Ländern jeweils übliche Praxis als auch ihre eigene fachliche Sichtweise dar.
|Saal 2||15:00 - 16:15||28.09.2019|
|To Inject or Not to Inject? - Antibiotics in Cataract Surgery - FEOph Symposium and Roundtable Discussion|
Antibiotics intravitreal injections are the reference treatment for post cataract endophthalmitis. Which antibiotics should we choose? How often? Which dose? Are antibiotics toxic for the eye? Should we add systemic antibiotics?
Since the bacteria most frequently causing postoperative endophthalmitis are present on the conjunctiva and skin of the patient, identification of risk factors is mandatory. Patients with blepharitis, living in a nosocomy, prosthesis carrier, with immunodeficiency require identification and special attention. Usefulness of preoperative antibiotics has yet to be proven, while antiseptics, of routine intraoperative use since many decades, are gaining acceptance also in the immediate preoperative period. Intracameral antibiotics significantly reduced the incidence of endophthalmitis, but need to be carefully selected. Postoperative use of antibiotics remains at discretion of the ophthalmologist. Their corneal penetration is important, but once endophthalmitis starts the treatment requires aggressive, intraocular approach. Immediate postoperative use of antibiotics with a wide spectrum of activity also on multiresistant bacteria may be determinant.
A retrospective study has been carried out in 205.465 eyes that underwent phacoemulsification and intraocular lense (IOL) implantation. The purpose was to investigate the incidence of endophtalmitis after using intracameral cefuroxime compared to intracameral vancomicine. No statistical differences were found.
Endophthalmitis is a sight threatening infection inside the eye; a rare, but serious complication of cataract surgery. Cataract surgery is currently the most commonly performed elective surgical procedure in the UK. Providers of cataract care and surgeons should be familiar with measures to prevent Endophthalmitis, such as administering intracameral cefuroxime at the time of surgery.