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Topical Antibiotics Before Cataract Surgery
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To the Editor: In their Contempo Updates article about treating age-related cataracts, Drs Solomon and Donnenfeld1 provided no evidence to support their assertion that, "Postoperatively, a patient is often started on topical eye drops, antibiotics to prevent infection (fourth-generation fluoroquinolones [gatifloxacin or moxifloxacin]), . . . ." Although topical antibiotics are part of the typical regimen to prevent postoperative infections in patients receiving cataract surgery, the newest addition to our antibiotic arsenal, topical fourth-generation fluoroquinolones, have not been shown in controlled studies to be better than existing agents.
Acute postoperative endophthalmitis is caused primarily by gram-positive bacteria (coagulase negative staphylococci, Staphylococcus aureus, and streptococci) with gram-negative organisms making up a small proportion of the total.2 Prophylaxis of intraocular infection begins with preoperative control of external disease, such as chronic blepharitis or lacrimal drainage infections. Many topical antibiotics have been shown to significantly reduce bacterial counts when given before surgery.3-4 These . . . [Full Text of this Article]
Stephen Sauer, MD
Department of Ophthalmology and Visual Sciences
University of Wisconsin
Madison
RELATED LETTER
Recent Advances and Future Frontiers in Treating Age-Related Cataracts
Renée Solomon and Eric D. Donnenfeld
JAMA. 2003;290(2):248-251.
EXTRACT
| FULL TEXT
RELATED ARTICLE
Topical Antibiotics Before Cataract Surgery—Reply
Eric D. Donnenfeld and Renée Solomon
JAMA. 2003;290(22):2938.
EXTRACT
| FULL TEXT
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