Intracameral antibiotics for endophthalmitis prophylaxis in cataract surgery: a meta-analysis
Bibliographic record
Abstract
Purpose Despite numerous studies, there is no consensus on the use of intracameral (IC) antibiotics to prevent postoperative endophthalmitis (POE) after cataract surgery.Methods A systematic search of Ovid MEDLINE, EMBASE, and Cochrane CENTRAL (inception–April 2021; PROSPERO ID: CRD42021248702) identified studies reporting POE risk in eyes treated with or without IC antibiotics. Study quality was assessed using the Cochrane risk-of-bias tool and Newcastle-Ottawa Scale. Meta-analysis was conducted using a random-effects model.Results Among 23 studies (2 RCTs, 21 observational; 5,442,686 eyes), POE incidence was lower with IC antibiotic use (0.038% vs. 0.096%, RR: 0.15, CI: [0.10, 0.23], ARR: 0.058, p < 0.001). In phacoemulsification cases, POE was 0.043% with IC antibiotics vs. 0.14% without (RR: 0.11, CI: [0.06, 0.20], ARR: 0.097, p < 0.001). POE risk was lower with combined IC and topical antibiotics (0.02% vs. 0.056%, RR: 0.40, p < 0.001). Gram-positive bacteria were more common in POE cases without IC antibiotics; gram-negatives were more frequent with IC use.Conclusions IC antibiotics reduced POE risk, though evidence quality was low to very low due to potential confounding. More rigorous studies accounting for surgical technique, antiseptic use, and adjunctive antibiotics are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.024 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.022 | 0.063 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".