The European Society of
Cataract & Refractive Surgeons
Endophthalmitis Study published preliminary results in 2006 showing a near 5-fold decrease in the rates of postoperative
endophthalmitis with the use of intracameral
cefuroxime. The study findings have generated considerable controversy, and 1 year later its recommendations had been heeded by only 6% of American Society of
Cataract and
Refractive Surgery (ASCRS) members. This poll sought to gauge the uptake among surgeons in the United Kingdom and survey their response to its findings. Fifty-five percent of respondents were using intracameral
cefuroxime; 48% had switched after publication of the ESCRS study. Of those remaining, 68% reported their main concern was the risk for dilution errors in the absence of a commercially preformulated preparation, with 67% stating they would switch if such a product became available. Sixty-eight percent considered the lack of a subconjunctival
cefuroxime treatment arm within the study a major methodology flaw. Sixty-seven percent said they do not consider
penicillin allergy a
contraindication to intracameral
cefuroxime use, with the remaining 33% opting for alternative
antibiotic prophylaxis. The majority of United Kingdom and Ireland Society of
Cataract and Refractive Surgeons members have switched to intracameral
cefuroxime, despite the absence of previously preferred practice in the study design. The major barrier to its further use appears to be the lack of a commercially available preformulated preparation.