Efectividad del moxifloxacino intracameral para reducir la Endoftalmitis posterior a cirugía de cataratas en población chilena
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Date
2023
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Abstract
Estudio de cohorte no concurrente cuyo propósito fue evaluar la efectividad del moxifloxacino intracameral profiláctico para reducir la frecuencia de endoftalmitis posterior a cirugía de cataratas en el Hospital Dr. Sótero del Río. Se revisaron todos los registros quirúrgicos entre el 2012 y el 2020, evaluando si se utilizó moxifloxacino intracameral. Posteriormente se registraron todos los pacientes que recibieron tratamiento por endoftalmitis, y se evaluaron sus características, si hubo uso de moxifloxacino y si la cirugía tuvo alguna complicación. Se encontraron 22.869 cirugías de cataratas, con un promedio de 2.541 operaciones anuales. El moxifloxacino intracameral se comenzó a usar el 2014 progresivamente, ocupándose en un 80% de las cirugías en el 2018. 15 ojos evolucionaron con endoftalmitis. Hubo una tendencia a favor del uso de moxifloxacino intracameral, sin embargo, esto no fue estadísticamente significativo. En el grupo de endoftalmitis, 33,3% tenían diabetes mellitus, en 13,3% hubo rotura de capsula posterior y 60% eran de pacientes mujeres. No hay registro de endoftalmitis entre el 2018 y el 2020 luego de cirugía de cataratas. En conclusión, a pesar de haber una tendencia a favor del uso de moxifloxacino intracameral, se requiere un periodo mayor de observación para confirmar esta hipótesis.
Background: Endophthalmitis is a serious infectious complication of cata ract surgery, which may lead to vision loss. Aim: To evaluate the effectiveness of intracameral moxifloxacin in reducing endophthalmitis after cataract surgery in Chilean patients. Material and Methods: We reviewed all phacoemulsification surgeries performed between 2012 and 2020 at a public hospital. The use of intraoperative intracameral moxifloxacin and possible surgical complications were recorded. In patients with postoperative endophthalmitis, we reviewed their risk factors and clinical characteristics. Results: In the study, 22,869 phacoemulsification surgeries were registered, with an annual average of 2,541. The use of prophylactic intracameral moxifloxacin started progressively in 2014. In 2018 it was used in 88% of the surgeries. Fifteen eyes evolved with postoperative endophthalmitis, but none of these surgeries used intracameral moxifloxacin. Five and seven cases occurred in 2012 and 2013, respectively. There was a trend favoring moxifloxacin use, as a preventive measure for endophthalmitis, but the difference between groups was not significant (p = 0.56). In the group with endophthalmitis, 33.3% of the eyes were from patients with type 2 diabetes mellitus, in 13.3% there was rupture of the posterior capsule and 60% of the eyes corresponded to female patients. Since 2018 there is no record of endophthalmi tis after cataract surgery performed in this center. Conclusions: Intracameral moxifloxacin showed a tendency to reduce the frequency of endophthalmitis after phacoemulsification surgery, but a longer observation period is required to reach statistical significance, due to the low frequency of this complication.
Background: Endophthalmitis is a serious infectious complication of cata ract surgery, which may lead to vision loss. Aim: To evaluate the effectiveness of intracameral moxifloxacin in reducing endophthalmitis after cataract surgery in Chilean patients. Material and Methods: We reviewed all phacoemulsification surgeries performed between 2012 and 2020 at a public hospital. The use of intraoperative intracameral moxifloxacin and possible surgical complications were recorded. In patients with postoperative endophthalmitis, we reviewed their risk factors and clinical characteristics. Results: In the study, 22,869 phacoemulsification surgeries were registered, with an annual average of 2,541. The use of prophylactic intracameral moxifloxacin started progressively in 2014. In 2018 it was used in 88% of the surgeries. Fifteen eyes evolved with postoperative endophthalmitis, but none of these surgeries used intracameral moxifloxacin. Five and seven cases occurred in 2012 and 2013, respectively. There was a trend favoring moxifloxacin use, as a preventive measure for endophthalmitis, but the difference between groups was not significant (p = 0.56). In the group with endophthalmitis, 33.3% of the eyes were from patients with type 2 diabetes mellitus, in 13.3% there was rupture of the posterior capsule and 60% of the eyes corresponded to female patients. Since 2018 there is no record of endophthalmi tis after cataract surgery performed in this center. Conclusions: Intracameral moxifloxacin showed a tendency to reduce the frequency of endophthalmitis after phacoemulsification surgery, but a longer observation period is required to reach statistical significance, due to the low frequency of this complication.
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Keywords
Cataract, Moxifloxacin, Endophthalmitis, Antibiotic Prophylaxis