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Role of intravitreal/intracameral antibiotics to prevent traumatic endophthalmitis - Meta-analysis.
Indian J Ophthalmol. 2017 Oct; 65(10):920-925.IJ

Abstract

Traumatic endophthalmitis is a devastating condition that can occur following an open globe injury and result in loss of vision. The use of prophylactic antibiotics is empirical as most surgeons fear complications associated with the same. No systematic review has been performed in English on the role of intravitreal/intracameral antibiotics in preventing traumatic endophthalmitis. We searched for randomized controlled trials and controlled clinical trials comparing intracameral/intravitreal antibiotics with placebos on PubMed, Google Scholar, Science Direct, and Cochrane Library using keywords open globe/trauma/penetrating/perforating injuries endophthalmitis. The last search was on 5 May 2017. We included patients of all ages with open globe injuries who received intracameral/intravitreal antibiotics, regardless of the dose. Quality of the trials was assessed using Cochrane collaboration tools to assess the risk of bias. The main outcome measures were endophthalmitis and visual acuity. We included three trials. Overall, intravitreal/intracameral antibiotics were noted to significantly reduce the occurrence of endophthalmitis in open globe injuries (relative risk [RR] 0.19, 95% confidence interval [CI] 0.06-0.57). The use of intravitreal/intracameral antibiotics did not have an effect in improving visual acuity (RR 1.17, 95% CI 0.61-2.23). Two trials (Narang 2003; Soheilan 2001) were observed to have no significant effect on visual acuity while another trial (Soheilan 2007) did not list visual acuity as part of its objectives. Intracameral/intravitreal antibiotics reduce the risk of endophthalmitis in open globe injuries; although, there was no improvement in the visual acuity. We, therefore, recommend the use of intravitreal/intracameral injections in open globe injuries to prevent this devastating complication.

Authors+Show Affiliations

Department of Ophthalmology, Hospital Melaka, Melaka, Malaysia.Department of Community Medicine, Melaka Manipal Medical College, Melaka, Malaysia.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

29044054

Citation

Thevi, Thanigasalam, and Adinegara Lutfi Abas. "Role of Intravitreal/intracameral Antibiotics to Prevent Traumatic Endophthalmitis - Meta-analysis." Indian Journal of Ophthalmology, vol. 65, no. 10, 2017, pp. 920-925.
Thevi T, Abas AL. Role of intravitreal/intracameral antibiotics to prevent traumatic endophthalmitis - Meta-analysis. Indian J Ophthalmol. 2017;65(10):920-925.
Thevi, T., & Abas, A. L. (2017). Role of intravitreal/intracameral antibiotics to prevent traumatic endophthalmitis - Meta-analysis. Indian Journal of Ophthalmology, 65(10), 920-925. https://doi.org/10.4103/ijo.IJO_512_17
Thevi T, Abas AL. Role of Intravitreal/intracameral Antibiotics to Prevent Traumatic Endophthalmitis - Meta-analysis. Indian J Ophthalmol. 2017;65(10):920-925. PubMed PMID: 29044054.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of intravitreal/intracameral antibiotics to prevent traumatic endophthalmitis - Meta-analysis. AU - Thevi,Thanigasalam, AU - Abas,Adinegara Lutfi, PY - 2017/10/19/entrez PY - 2017/10/19/pubmed PY - 2017/12/19/medline SP - 920 EP - 925 JF - Indian journal of ophthalmology JO - Indian J Ophthalmol VL - 65 IS - 10 N2 - Traumatic endophthalmitis is a devastating condition that can occur following an open globe injury and result in loss of vision. The use of prophylactic antibiotics is empirical as most surgeons fear complications associated with the same. No systematic review has been performed in English on the role of intravitreal/intracameral antibiotics in preventing traumatic endophthalmitis. We searched for randomized controlled trials and controlled clinical trials comparing intracameral/intravitreal antibiotics with placebos on PubMed, Google Scholar, Science Direct, and Cochrane Library using keywords open globe/trauma/penetrating/perforating injuries endophthalmitis. The last search was on 5 May 2017. We included patients of all ages with open globe injuries who received intracameral/intravitreal antibiotics, regardless of the dose. Quality of the trials was assessed using Cochrane collaboration tools to assess the risk of bias. The main outcome measures were endophthalmitis and visual acuity. We included three trials. Overall, intravitreal/intracameral antibiotics were noted to significantly reduce the occurrence of endophthalmitis in open globe injuries (relative risk [RR] 0.19, 95% confidence interval [CI] 0.06-0.57). The use of intravitreal/intracameral antibiotics did not have an effect in improving visual acuity (RR 1.17, 95% CI 0.61-2.23). Two trials (Narang 2003; Soheilan 2001) were observed to have no significant effect on visual acuity while another trial (Soheilan 2007) did not list visual acuity as part of its objectives. Intracameral/intravitreal antibiotics reduce the risk of endophthalmitis in open globe injuries; although, there was no improvement in the visual acuity. We, therefore, recommend the use of intravitreal/intracameral injections in open globe injuries to prevent this devastating complication. SN - 1998-3689 UR - https://www.unboundmedicine.com/medline/citation/29044054/Role_of_intravitreal/intracameral_antibiotics_to_prevent_traumatic_endophthalmitis___Meta_analysis_ L2 - http://www.ijo.in/article.asp?issn=0301-4738;year=2017;volume=65;issue=10;spage=920;epage=925;aulast=Thevi DB - PRIME DP - Unbound Medicine ER -