PATTERNS OF PERIOPERATIVE PROPHYLAXIS FOR CATARACT-SURGERY - A SURVEYOF AUSTRALIAN OPHTHALMOLOGISTS

Background: Although peri-operative prophylaxis to prevent endophthalm itis is commonly practised by ophthalmologists, no one method has clea rly been demonstrated to be more effective than another: We surveyed 5 70 Fellows of the Royal Australian College of Ophthalmologists to dete rmine what their methods of prophylaxis were and whether these differe d for patients who developed endophthalmitis. Methods: The questionnai re asked about the types of antibiotics and other methods of prophylax is used before, during and after cataract surgery. Of those who report ed cases of endophthalmitis, we asked specifically about the methods o f prophylaxis used for those patients. Results: The response was 89% a nd the incidence of endophthalmitis was calculated as 0.11%. There was little difference in the methods of prophylaxis used by those who rep orted endophthalmitis compared with others, but pre-operative antibiot ics were used more commonly by those who reported the disease (P = 0.0 6). Surgeons who had practised for 20 years or more reported a lower r ate of endophthalmitis than others, as did those who performed more th an 300 cataract operations per year. However; the pattern of prophylax is used by these two sub-groups was quite divergent. Differences in th e methods of prophylaxis had no bearing on the development of endophth almitis, with the exception that subconjunctival antibiotics were used less often in those patients who developed the disease (P = 0.03). Co nclusions: The results of the present study provide no clear answer re garding appropriate peri-operative prophylaxis. The wide range of prop hylactic regimens used suggests that no one method is superior to anot her. Formal case-controlled studies are required to identify method wo uld be most efficacious.