| Perioperative antibiotics for prevention of endophthalmitis after cataract surgery |
| Population: participants undergoing cataract surgery Settings: eye hospital or clinic Outcome: risk of endophthalmitis after surgery |
| Sobaci 2003 | 644 eyes of 640 participants | 6 weeks | Treatment: BSS with antibiotics (vancomycin 20 mg/mL and gentamicin 8 mg/mL) | Not reported | 0/322 (0%) eyes | Not reported | 0.20 (0.01 to 4.15) | ⊕⊝⊝⊝
Very low1,2 |
| Control: BSS‐only irrigating infusion fluid | Not reported | 2/322 (0.62%) eyes |
| ESCRS 2007 | 16,603 eyes of 16,603 participants | 6 weeks | Treatment 1: combined intracameral cefuroxime and topical levofloxacin | 2/4052 (0.05%) eyes | 1/4052 (0.02%) eyes | 0.14 (0.03 to 0.63) | 0.10 (0.01 to 0.78) | ⊕⊕⊕⊕
High |
| Treatment 2: intracameral cefuroxime 0.9% | 3/4056 (0.07%) eyes | 2/4056 (0.05%) eyes | 0.21 (0.06 to 0.74) | 0.20 (0.04 to 0.91) | ⊕⊕⊕⊕
High |
| Treatment 3: topical levofloxacin 0.5% | 10/4049 (0.25%) eyes | 7/4049 (0.17%) eyes | 0.72 (0.32 to 1.61) | 0.70 (0.27 to 1.84) | ⊕⊕⊕⊝
Moderate3 |
| Control: placebo drops | 14/4054 (0.35%) eyes | 10/4054 (0.25%) eyes |
| Christy 1979 | 6618 eyes of 6618 participants | 1 week | Treatment 1: combined prophylaxis (topical regimen + periocular penicillin at the time of surgery) | 5/3309 (0.15%) eyes | Not reported | 0.33 (0.12 to 0.92) | Not reported | ⊕⊕⊕⊝
Moderate4 |
| Treatment 2: topical regimen alone (chloramphenicol‐sulfadimidine) | 15/3309 (0.45%) eyes | Not reported |
| ESCRS 2007 | 16,603 eyes of 16,603 participants | 6 weeks | Treatment 1: combined intracameral cefuroxime and topical levofloxacin | 2/4052 (0.05%) eyes | 1/4052 (0.02%) eyes | Treatment 1 vs treatment 2: 0.67 (0.11 to 3.99) | Treatment 1 vs treatment 2: 0.50 (0.05 to 5.52) | ⊕⊕⊕⊝
Moderate3 |
| Treatment 2: intracameral cefuroxime 0.9% | 3/4056 (0.07%) eyes | 2/4056 (0.05%) eyes | Treatment 2 vs treatment 3: 0.30 (0.08 to 1.09) | Treatment 2 vs treatment 3: 0.29 (0.06 to 1.37) | ⊕⊕⊕⊝
Moderate3 |
| Treatment 3: topical levofloxacin 0.5% | 10/4049 (0.25%) eyes | 7/4049 (0.17%) eyes | Treatment 1 vs treatment 3: 0.20 (0.04 to 0.91) | Treatment 1 vs treatment 3: 0.14 (0.02 to 1.16) | ⊕⊕⊕⊕
High |
| Christy 1986 | 77,015 eyes of 77,015 participants | 1 week | Mode 1: Anterior sub‐Tenon injections (subconjunctival) | 38/39,752 (0.10%) eyes | Not reported | 0.85 (0.55 to 1.32) | Not reported | ⊕⊕⊕⊝
Moderate4 |
| Mode 2: Posterior sub‐Tenon injections (retrobulbar) | 42/37,263 (0.11%) eyes | Not reported |
| Cunha 2013 | 108 eyes of 108 participants | 3 weeks | Treatment 1: fixed combination of topical gatifloxacin 0.3% and prednisolone acetate 1% | 0/47 (0%) eyes | Not reported | 0.43 (0.02 to 10.34) | Not reported | ⊕⊝⊝⊝
Very low1,5 |
| Treatment 2: individual instillation of topical gatifloxacin 0.3% and prednisolone acetate 1% | 1/61 (2%) eyes | Not reported |
| GRADE Working Group grades of evidence
High‐certainty: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate‐certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low‐certainty: We are very uncertain about the estimate. |
