While the application of topical antibiotic eye drops alongside intracameral antibiotic administration is a common practice following ocular surgery, researchers in Barcelona are wary of the subsequent instillation of eye drops. Even though the topical administration of antibiotics has been questioned, it is still common practice with many surgeons.

A retrospective study assessed the role of topical azithromycin or topical ciprofloxacin in addition to what is considered the standard of care in preventing infectious postoperative endophthalmitis—intracameral cefuroxime or vancomycin—in a long series of cataract surgeries. The team found that the risk for post-op endophthalmitis was the same with perioperative topical ciprofloxacin than with topical azithromycin.

A total of 15,146 cataract surgeries were conducted—10,756 in group I and 4,390 in group II. Two cases of post-op endophthalmitis were diagnosed in each group, showing a 0.019% and 0.046% rate respectively and not statistically significant. Instead, the cases were cases were related with aging, systemic and ocular comorbidities or with a complicated cataract surgery.

The researchers concluded that the application of topical antibiotics in addition to the intracameral antibiotic administration is a practice that should be avoided, since there is no benefit observed and their use could increase antibiotic-resistant bacterial strains.

Tuñí-Picado J, Martínez-Palmer A, Fernández-Sala X, et al. Infectious postoperative endophthalmitis after cataract surgery performed over seven years. The role of azithromycin versus ciprofloxacin eye drops. Rev Esp Quimioter. 2018;31(6):499-505.