The effectiveness of antibiotic additives in irrigation fluid used during cataract surgery: A systematic review
Notice bibliographique
Résumé
Purpose To conduct a systematic review investigating the efficacy of antibiotics used in irrigation fluid during cataract surgery on the incidence of post-operative endophthalmitis. Design Systematic review of literature. Methods Literature was searched through MEDLINE, EMBASE, CINAHL, Clinical Trials.gov, and ProQuest Dissertations and Theses until February 17, 2024. Conferences held through Association for Research in Vision and Ophthalmology and American Academy of Ophthalmology were searched until March 22, 2024. A total of 5341 records were screened leaving 13. One author independently reviewed them for quality and extracted data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were followed. Data on the types of antibiotics used, as well as the incidence of post-operative endophthalmitis and complications, were extracted. Results A total of 608,064 eyes and 566,760 patients were included in the current study. Surgical procedures included phacoemulsification, manual small-incision, and extracapsular extraction. Results showed antibiotic additives reduced postoperative endophthalmitis and bacterial contamination. Vancomycin showed the lowest infection rates, with one study reporting 0 infections out of 220 patients using a concentration of 20 mg/L. Similarly, gentamicin, tobramycin, and cefuroxime also demonstrated reduced infection rates, with gentamicin achieving rates as low as 0.008% at higher concentrations. Combination therapy with vancomycin and gentamicin further reduced bacterial contamination, with culture positivity rates as low as 2.73%. In comparator groups without antibiotics, infection rates were significantly higher, ranging from 0.04% to 0.07%. No adverse events or complications were reported in those who received antibiotics in their irrigation fluid. Conclusions Antibiotic additives in irrigation fluid reduce postoperative endophthalmitis and bacterial contamination in cataract surgery. These findings support their inclusion in surgical practice to improve patient outcomes. Based on the current systematic review, the overall quality of evidence is moderate, as findings are supported by a mix of randomized controlled trials and observational studies with some heterogeneity. Further high-quality RCTs are needed to determine optimal antibiotic concentrations and establish standardized guidelines.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».