Hot Topics in Perioperative Antibiotics for Cataract Surgery.

BACKGROUND: Acute-onset postoperative endophthalmitis is an uncommon but potentially serious complication of cataract surgery. Since there are relatively few randomized clinical trials comparing the timing and administration of prophylactic antibiotics, there are wide variations in prevention practices around the world.

METHODS: Literature review.

RESULTS: Antibiotics may be used before surgery, during surgery, or after surgery in an attempt to decrease the rates of endophthalmitis. Antibiotics may be delivered by various routes, including topical, subconjunctival, in the irrigating solution, or by bolus intracameral injection. Polymerase chain reaction and other DNA identification techniques for bacterial isolates and their antibiotic sensitivity profiles will play an important role in future management strategies.

CONCLUSION: There is no consensus regarding the precise use of antibiotics in the perioperative period. Because of increased multidrug-resistant bacteria, evolving strategies are needed to address these issues.