Effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis after cataract surgery

Objective To evaluate the clinical effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis in patients after cataract surgery. Methods We retrospectively collected the clinical data from 28 845 patients undergoing cataract surgery in our...

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Main Authors: TAO Li, LIU Wei, YE Jian
Format: Article
Language:zho
Published: Editorial Office of Journal of Third Military Medical University 2020-10-01
Series:Di-san junyi daxue xuebao
Subjects:
Online Access:http://aammt.tmmu.edu.cn/Upload/rhtml/202005210.htm
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author TAO Li
LIU Wei
YE Jian
author_facet TAO Li
LIU Wei
YE Jian
author_sort TAO Li
collection DOAJ
description Objective To evaluate the clinical effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis in patients after cataract surgery. Methods We retrospectively collected the clinical data from 28 845 patients undergoing cataract surgery in our hospital between January 2016 and December 2019, who received injection of low-concentration vancomycin (0.01 mg/mL, 0.1 mL; 13 068 eyes in 7 318 cases) or cefuroxime (10 mg/mL, 0.1 mL; 15 777 eyes in 8 935 cases) in the anterior chamber at the end of surgery for prevention of endophthalmitis. The patients' postoperative visual acuity, intraocular pressure, cornea, anterior chamber and intraocular lens under slit lamp, vitreous opacity with B-mode ultrasound, and laboratory culture results were analyzed to identify the patients with infectious endophthalmitis, and the treatments and outcomes of the patients were analyzed. Results The incidence of postoperative infectious endophthalmitis was 0.022 9% (3 eyes in 3 cases) in low-concentration vancomycin group and 0.012 7% (2 eyes in 2 cases) in cefuroxime group, showing a significant difference between the 2 groups (P < 0.025). The results of bacterial culture identified cases of infections with Pseudomonas aeruginosa (1 case) and Staphylococcus epidermidis (2 cases) in low-concentration vancomycin group and infections with fungus (1 case) and Streptococcus mitis (1 case) in cefuroxime group. The clinical manifestations of infectious endophthalmitis in the identified cases did not differ significantly between the cefuroxime group and vancomycin group. The treatments of postoperative endophthalmitis included anterior chamber washing and drug injection, intravitreal drug injection, vitrectomy, systemic antibiotic infusion, and local hormone/antibiotic treatment. After the treatments, the visual acuity was improved in all cases in vancomycin group, but remained unchanged in one case and deteriorated in another in cefuroxime group. None of the patients required enucleation. Conclusion The clinical effect of low-concentration vancomycin injection in the anterior chamber is not inferior to that of cefuroxime injection for prevention of postoperative infectious endophthalmitis after cataract surgery.
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spelling doaj.art-d6c885d7509047399a0134cc9b29de822022-12-21T23:30:14ZzhoEditorial Office of Journal of Third Military Medical UniversityDi-san junyi daxue xuebao1000-54042020-10-0142202057206210.16016/j.1000-5404.202005210Effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis after cataract surgeryTAO Li0LIU Wei1YE Jian2Department of Ophthalmology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China Department of Ophthalmology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China Department of Ophthalmology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China Objective To evaluate the clinical effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis in patients after cataract surgery. Methods We retrospectively collected the clinical data from 28 845 patients undergoing cataract surgery in our hospital between January 2016 and December 2019, who received injection of low-concentration vancomycin (0.01 mg/mL, 0.1 mL; 13 068 eyes in 7 318 cases) or cefuroxime (10 mg/mL, 0.1 mL; 15 777 eyes in 8 935 cases) in the anterior chamber at the end of surgery for prevention of endophthalmitis. The patients' postoperative visual acuity, intraocular pressure, cornea, anterior chamber and intraocular lens under slit lamp, vitreous opacity with B-mode ultrasound, and laboratory culture results were analyzed to identify the patients with infectious endophthalmitis, and the treatments and outcomes of the patients were analyzed. Results The incidence of postoperative infectious endophthalmitis was 0.022 9% (3 eyes in 3 cases) in low-concentration vancomycin group and 0.012 7% (2 eyes in 2 cases) in cefuroxime group, showing a significant difference between the 2 groups (P < 0.025). The results of bacterial culture identified cases of infections with Pseudomonas aeruginosa (1 case) and Staphylococcus epidermidis (2 cases) in low-concentration vancomycin group and infections with fungus (1 case) and Streptococcus mitis (1 case) in cefuroxime group. The clinical manifestations of infectious endophthalmitis in the identified cases did not differ significantly between the cefuroxime group and vancomycin group. The treatments of postoperative endophthalmitis included anterior chamber washing and drug injection, intravitreal drug injection, vitrectomy, systemic antibiotic infusion, and local hormone/antibiotic treatment. After the treatments, the visual acuity was improved in all cases in vancomycin group, but remained unchanged in one case and deteriorated in another in cefuroxime group. None of the patients required enucleation. Conclusion The clinical effect of low-concentration vancomycin injection in the anterior chamber is not inferior to that of cefuroxime injection for prevention of postoperative infectious endophthalmitis after cataract surgery.http://aammt.tmmu.edu.cn/Upload/rhtml/202005210.htmvancomycincefuroximeinfective endophthalmitis
spellingShingle TAO Li
LIU Wei
YE Jian
Effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis after cataract surgery
Di-san junyi daxue xuebao
vancomycin
cefuroxime
infective endophthalmitis
title Effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis after cataract surgery
title_full Effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis after cataract surgery
title_fullStr Effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis after cataract surgery
title_full_unstemmed Effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis after cataract surgery
title_short Effect of low-concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis after cataract surgery
title_sort effect of low concentration vancomycin injection in the anterior chamber for prevention of infectious endophthalmitis after cataract surgery
topic vancomycin
cefuroxime
infective endophthalmitis
url http://aammt.tmmu.edu.cn/Upload/rhtml/202005210.htm
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AT liuwei effectoflowconcentrationvancomycininjectionintheanteriorchamberforpreventionofinfectiousendophthalmitisaftercataractsurgery
AT yejian effectoflowconcentrationvancomycininjectionintheanteriorchamberforpreventionofinfectiousendophthalmitisaftercataractsurgery