Choosing wisely and the use of antibiotics in ophthalmic surgery: There is more than meets the eye

Abstract

Background:

One of the directions of modern ophthalmology is toward an odontoiatric model, and new settings of eye care are becoming the standard of care: one day surgery and also office-based therapies.

Methods:

Retrospective analysis of three tertiary-care centers in Italy and analysis of the literature.

Results:

We provide readers with state-of-the-art measures of prophylaxis in ophthalmic surgery.

Discussion and conclusion:

Role of antibiotics is criticized in the light of stewardship antimicrobial paradigm.

Keywords

Endophthalmitis antibiotics choosing wisely paradigm appropriateness ophthalmic surgery

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References

Lundström

Wendel

Duration of self assessment benefit of cataract extraction: a long term study. Br J Ophthalmol 2005; 89: 1017–1020.

Busbee

Brown

et al . Incremental cost-effectiveness of initial cataract surgery. Ophthalmology 2002; 109: 606–613.

World Health Organization. Global initiative for elimination of avoidable blindness. WHO/PBL/97.61 Rev 2. Geneva: World Health Organization, 2000.

Klein

BEK

Howard

Lee

et al . Changing incidence of lens extraction over twenty years: the Beaver Dam Eye Study. Ophthalmology 2014; 121: 5–9.

Grosso

Arias

Mariotti

et al . Recent advancements in vitreoretinal techniques—a critical reappraisal. Eur Ophthalmic Rev 2014; 8(1): 46–52.

Englander

Chen

Paschalis

et al . Intravitreal injections at the Massachusetts Eye and Ear Infirmary: analysis of treatment indications and postinjection endophthalmitis rates. Br J Ophthalmol 2013; 97: 460–465.

Kim

Chomsky

Sternberg

Jr.

Reducing the risk of endophthalmitis after intravitreous injection. JAMA Ophthalmol 2013; 131(5): 674–675.

Hsu

Gerstenblith

Garg

et al . Conjunctival flora antibiotic resistance patterns after serial intravitreal injections without postinjection topical antibiotics. Am J Ophthalmol 2014; 157: 514–518.

Grosso

A critical debate about the prophylaxis strategies in patients who undergo intravitreal injections is warranted. Retina 2008; 28(10): 1556–1559.

10.

Alabiad

Miller

Schiffman

et al . Antimicrobial resistance profiles of ocular and nasal flora in patients undergoing intravitreal injections. Am J Ophthalmol 2011; 152(6): 999–1004.

11.

Abell

Kerr

Allen

et al . Intravitreal injections: is there benefit for a theatre setting? Br J Ophthalmol 2012; 96(12): 1474–1478.

12.

Brynskov

Kemp

Sørensen

TL.

No cases of endophthalmitis after 20,293 intravitreal injections in an operating room setting. Retina 2014; 34(5): 951–957.

13.

Tabandeh

Boscia

Sborgia

et al . Endophthalmitis associated with intravitreal injections: office-based setting and operating room setting. Retina 2014; 34(1): 18–22.

14.

Parke

2nd Coleman

Rich

et al . Choosing wisely: five ideas that physicians and patients can discuss. Ophthalmology 2013; 120(3): 443–444.

15.

Grosso

Pertile

Marchini

et al . Adherence to European Society for Cataract and Refractive Surgery recommendations amongst Italian cataract surgeons: a survey. Eur J Ophthalmol 2016; 26(5): 398–404.

16.

Cao

Zhang

et al . Risk factors for acute endophthalmitis following cataract surgery: a systematic review and meta-analysis. PLoS ONE 2013; 8(8): e71731.

17.

Endophthalmitis Study Group European Society of Cataract Refractive Surgeons. Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg 2007; 33(6): 978–988.

18.

Barry

Cordoves

Gradner

ESCRS guidelines for prevention and treatment of endophthalmitis following cataract surgery: data, dilemmas and conclusions

2013, www.escrs.org (accessed July 2014).

19.

Fayers

Loh

Cordeiro

et al . Overprescribing of antibiotics by UK ophthalmologists. Eye 2018; 32(2): 240–242.

20.

Matsuura

Mori

Miyamoto

et al . Survey of Japanese ophthalmic surgeons regarding perioperative disinfection and antibiotic prophylaxis in cataract surgery. Clin Ophthalmol 2014; 8: 2013–2018.

21.

Beselga

Campos

Castro

et al . Postcataract surgery endophthalmitis after introduction of the ESCRS protocol: 5-year study. Eur J Ophthalmol 2014; 24(4): 516–519.

22.

Barry

Adoption of intracameral antibiotic prophylaxis of endophthalmitis following cataract surgery: update on the ESCRS Endophthalmitis Study. J Cataract Refract Surg 2014; 40(1): 142–138.

23.

Kam

Buck

Dawkins

et al . Survey of prophylactic intracameral antibiotic use in cataract surgery in an Australian context. Clin Exp Ophthalmol 2014; 42(4): 398–400.

24.

Scott

Flynn

Jr Dev

et al . Endophthalmitis after 25 gauge and 20 gauge pars plana vitrectomy: incidence and outcomes. Retina 2008; 28(1): 138–142.

25.

Recchia

Scott

Brown

et al .; Ophthalmic Technology Assessment Committee Retina Panel. Small gauge pars plana vitrectomy: a report by the American Academy of Ophthalmology. Ophthalmology 2010; 117(9): 1851–1857.

26.

Govetto

Virgili

Menchini

et al . A systematic review of endophthalmitis after microincisional versus 20g vitrectomy. Ophthalmology 2013; 120(11): 2286–2291.

27.

Bahrani

Fazelat

Thomas

et al . Endophthalmitis in the era of small gauge transconjunctival sutureless vitrectomy—meta analysis and review of the literature. Semin Ophthalmol 2010; 25(5–6): 275–282.

28.

Kaiser

Prenner

Scott

et al . The microsurgical safety task force: evolving guidelines for minimizing the risk of endophthalmitis associated with microincisional vitrectomy surgery. Retina 2010; 30(4): 692–699.

29.

Meredith

McCannel

Barr

et al . Postinjection endophthalmitis in the comparison of age-related macular degeneration treatments trials (CATT). Ophthalmology 2015; 122(4): 817–821.

30.

Figurska

[Azithromycin in prophylaxis of intravitreal injections in patients with wet age-related macular degeneration]. Klin Oczna 2011; 113(1–3): 38–41 (in Polish).

31.

Tominaga

Oshima

Wakabayashi

et al . Bacterial contamination of the vitreous cavity associated with transconjunctival 25-gauge microincision vitrectomy surgery. Ophthalmology 2010; 117(4): 811–817.

32.

Chen

Khurana

Nguyen

et al . The incidence of endophthalmitis following transconjunctival sutureless 25- vs 20-gauge vitrectomy. Eye 2009; 23(4): 780–784.

33.

Chang

Chianq

et al . Comparison of transconjunctival sutureless vitrectomy and standard 20 gauge vitrecto my for patients with cataract and vitreoretinal diseases. J Cataract Refract Surg 2005; 31: 1198–1207.

34.

Hwang

Yoon

Kim

et al . Combined phacoemulsification, foldable intraocular lens implantation, and 25-gauge transconjunctival sutureless vitrectomy. J Cataract Refract Surg 2006; 32: 727–731.

35.

Oshima

Ohji

Tano

Surgical outcomes of 25-gauge transconjunctival vitrectomy combined with cataract surgery for vitreoretinal diseases. Ann Acad Med Singapore 2006; 35(3): 175–180.

36.

Ayyala

Bellows

Thomas

et al . Bleb infections: clinically different courses of “blebitis” and endophthalmitis. Ophthalmic Surg Lasers 1997; 28(6): 452–460.

37.

Soltau

Rothman

Budenz

et al . Risk factors for glaucoma filtering bleb infections. Arch Ophthalmol 2000; 118(3): 338–342.

38.

Ciulla

Beck

Topping

et al . Blebitis, early endophthalmitis, and late endophthalmitis after glaucoma-filtering surgery. Ophthalmology 1997; 104(6): 986–995.

39.

Song

Scott

Flynn

Jr et al . Delayed-onset bleb-associated endophthalmitis: clinical features and visual acuity outcomes. Ophthalmology 2002; 109(5): 985–991.

40.

Jampel

Quigley

Kerrigan-Baumrind

et al .; Glaucoma Surgical Outcomes Study Group. Risk factors for late-onset infection following glaucoma filtration surgery. Arch Ophthalmol 2001; 119(7): 1001–1008.

41.

Yassin

SA.

Bleb-related infection revisited: a literature review. Acta Ophthalmol 2016; 94(2): 122–134.

42.

Ang

Varga

Shaarawy

Postoperative infection in penetrating versus non-penetrating glaucoma surgery. Br J Ophthalmol 2010; 94(12): 1571–1576.

43.

Mandalos

Sung

Glaucoma drainage device surgery in children and adults: a comparative study of outcomes and complications. Graefes Arch Clin Exp Ophthalmol 2017; 255: 1003–1011.

44.

Al-Torbak

Al-Shahwan

Al-Jadaan

et al . Endophthalmitis associated with the Ahmed glaucoma valve implant. Br J Ophthalmol 2005; 89(4): 454–458.

45.

Sidoti

Belmonte

Liebmann

et al . Trabeculectomy with mitomycin-C in the treatment of pediatric glaucomas. Ophthalmology 2000; 107(3): 422–429.

46.

Ehrlich

Snir

Lusky

et al . Augmented trabeculectomy in paediatric glaucoma. Br J Ophthalmol 2005; 89(2): 165–168.

47.

Wallin Al-ahramy

ÖAM

Lundström

Montan

Endophthalmitis and severe blebitis following trabeculectomy. Epidemiology and risk factors: a single-centre retrospective study. Acta Ophthalmol 2014; 92(5): 426–431.

48.

Brillat-Zaratzian

Bron

Aptel

et al . FRIENDS Group: clinical and microbiological characteristics of post-filtering surgery endophthalmitis. Graefes Arch Clin Exp Ophthalmol 2014; 252(1): 101–107.

49.

Mady

Holland

Bhagat

et al . Intraocular pressure outcomes after endophthalmitis associated with glaucoma surgery. J Glaucoma 2015; 24(2): 122–126.

50.

Aaberg

Jr Flynn

Jr Schiffman

et al . Nosocomial acute-onset postoperative endophthalmitis survey. A 10-year review of incidence and outcomes. Ophthalmology 1998; 105(6): 1004–1010.

51.

Eifrig

Flynn

Jr Scott

et al . Acute-onset postoperative endophthalmitis: review of incidence and visual outcomes (1995–2001). Ophthalmic Surg Lasers 2002; 33(5): 373–378. Erratum in: Ophthalmic Surg Lasers 2003; 34(1): 80.

52.

Kattan

Flynn

Jr Pflugfelder

et al . Nosocomial endophthalmitis survey. Current incidence of infection after intraocular surgery. Ophthalmology 1991; 98(2): 227–238.

53.

Kuo

et al . Nosocomial postoperative endophthalmitis: a 14-year review. Graefes Arch Clin Exp Ophthalmol 2006; 244(8): 920–929.

54.

Poulsen

Allingham

RR.

Characteristics and risk factors of infections after glaucoma filtering surgery. J Glaucoma 2000; 9(6): 438–443.

55.

Mochizuki

Jikihara

Ando

et al . Incidence of delayed onset infection after trabeculectomy with adjunctive mitomycin C or 5-fluorouracil treatment. Br J Ophthalmol 1997; 81(10): 877–883.

56.

Alwitry

King

AJ.

Surveillance of late-onset bleb leak, blebitis and bleb-related endophthalmitis—a UK incidence study. Graefes Arch Clin Exp Ophthalmol 2012; 250(8): 1231–1236.

57.

Freedman

Gupta

Bunke

Endophthalmitis after trabeculectomy. Arch Ophthalmol 1978; 96(6): 1017–1018.

58.

Katz

Cantor

Spaeth

GL.

Complications of surgery in glaucoma. Early and late bacterial endophthalmitis following glaucoma filtering surgery. Ophthalmology 1985; 92(7): 959–963.

59.

Collignon-Brach

[Surgery for glaucoma and endophthalmitis]. Bull Soc Belge Ophtalmol 1996; 260: 73–77.

60.

Wolner

Liebmann

Sassani

et al . Late bleb-related endophthalmitis after trabeculectomy with adjunctive 5-fluorouracil. Ophthalmology 1991; 98(7): 1053–1060.

61.

Uchida

Suzuki

Araie

et al . Long-term follow-up of initial 5-fluorouracil trabeculectomy in primary open-angle glaucoma in Japanese patients. J Glaucoma 2001; 10(6): 458–465.

62.

Greenfield

Suñer

Miller

et al . Endophthalmitis after filtering surgery with mitomycin. Arch Ophthalmol 1996; 114(8): 943–949.

63.

Higginbotham

Stevens

Musch

et al . Bleb-related endophthalmitis after trabeculectomy with mitomycin C. Ophthalmology 1996; 103(4): 650–656.

64.

DeBry

Perkins

Heatley

et al . Incidence of late-onset bleb-related complications following trabeculectomy with mitomycin. Arch Ophthalmol 2002; 120(3): 297–300.

65.

Sharan

Trope

Chipman

et al . Late-onset bleb infections: prevalence and risk factors. Can J Ophthalmol 2009; 44(3): 279–283.

66.

Yamamoto

Sawada

Mayama

et al .; Collaborative Bleb-Related Infection Incidence and Treatment Study Group. The 5-year incidence of bleb-related infection and its risk factors after filtering surgeries with adjunctive mitomycin C: collaborative bleb-related infection incidence and treatment study 2. Ophthalmology 2014; 121(5): 1001–1006.

67.

Kim

Law

Coleman

et al . Long-term bleb-related infections after trabeculectomy: incidence, risk factors, and influence of bleb revision. Am J Ophthalmol 2015; 159(6): 1082–1091.

68.

Zahid

Musch

Niziol

et al .; Collaborative Initial Glaucoma Treatment Study Group. Risk of endophthalmitis and other long-term complications of trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS). Am J Ophthalmol 2013; 155(4): 674–680.

69.

Vaziri

Kishor

Schwartz

et al . Incidence of bleb-associated endophthalmitis in the United States. Clin Ophthalmol 2015; 9: 317–322.

70.

Stein

Ruiz

Jr Belsky

et al . Longitudinal rates of postoperative adverse outcomes after glaucoma surgery among medicare beneficiaries 1994 to 2005. Ophthalmology 2008; 115(7): 1109–1116.

71.

Wentzloff

Grosskreutz

Pasquale

et al . Endophthalmitis after glaucoma drainage implant surgery. Int Ophthalmol Clin 2007; 47(2): 109–115.

72.

Zheng

Moster

Khan

et al . Infectious endophthalmitis after glaucoma drainage implant surgery: clinical features, microbial spectrum, and outcomes. Retina 2017; 37: 1160–1167.

73.

Al Rashaed

Arevalo

Al Sulaiman

et al . Endophthalmitis trends and outcomes following glaucoma surgery at a Tertiary Eye Care Hospital in Saudi Arabia. J Glaucoma 2016; 25(2): e70–e75.

74.

Roy

Mermoud

[Complications of deep nonpenetrating sclerectomy]. J Fr Ophtalmol 2006; 29(10): 1180–1197.

75.

Detry-Morel

Detry

MB.

Five-year experience with non penetrating deep sclerectomy. Bull Soc Belge Ophtalmol 2006; (299): 83–94.

76.

Anand

Arora

Clowes

Mitomycin C augmented glaucoma surgery: evolution of filtering bleb avascularity, transconjunctival oozing, and leaks. Br J Ophthalmol 2006; 90(2): 175–180.

77.

Anand

Pilling

Nd:YAG laser goniopuncture after deep sclerectomy: outcomes. Acta Ophthalmol 2010; 88(1): 110–115.

78.

Bissig

Rivier

Zaninetti

et al . Ten years follow-up after deep sclerectomy with collagen implant. J Glaucoma 2008; 17(8): 680–686.

79.

Wishart

Choudhary

et al . Long-term results of viscocanalostomy in pseudoexfoliative and primary open angle glaucoma. Clin Exp Ophthalmol 2008; 36(2): 148–155.

80.

Moss

Sanislo

CN.

A prospective randomized evaluation of topical gatifloxacin on conjunctival flora in patients undergoing intravitreal injections. Ophthalmology 2009; 116(8): 1498–1501.

81.

Yin

Weisbrod

Eng

et al . Antibiotic resistance of ocular surface flora with repeated use of a topical antibiotic after intravitreal injection. JAMA Ophthalmol 2013; 131(4): 456–461.

82.

Dave

Toma

Kim

SJ.

Changes in ocular flora in eyes exposed to ophthalmic antibiotics. Ophthalmology 2013; 120(5): 937–941.

83.

Zick

Joondeph

Is a postoperative day one examination needed after uncomplicated vitreoretinal surgery?

Retina, 2018 Feb; 38(2): 331–333.