Efectividad y costos de la cefuroxima intracameral en la profilaxis de la endoftalmitis poscirugía de catarata

Abstract

AimTo evaluate the effectiveness and cost of intracameral cefuroxime for postoperative endophthalmitis (PE) prophylaxis in Holguín's Ophthalmological Center. MethodsRetrospective consecutive cohort study including all patients undergoing cataract surgery in Holguín's Ophthalmological Center between January 2008 and June 2015. Patients were classified in 2 groups: Group 1 operated on between January 2008 and June 2010, with the use of subconjunctival gentamycin at the end of surgery and group 2 operated on between July 2010 and June 2015, in whom a 1mg/0.1 bolus of intracameral cefuroxime was instilled. The rates of PE were determined per year and groups of study as the effectiveness and cost of the 2 prophylactic methods. ResultsAt Holguín's Ophthalmological Center there were 27 reported cases of PE from 2008 to June 2015 from a total of 11,117 cataract procedures. The highest incidence was reached in 2009 with a rate of 0.83%. The mean incidence rate in group 1 was 0.85%, while in group 2 de mean incidence was 0.07%. Introduction of intracameral cefuroxime represented a significant reduction in the incidence of PE (P<.005). The relative risk for endophthalmitis in group 1 against group 2 was 13.3 times bigger. The use of cefuroxime resulted less expensive. Cost- effectiveness relationship for this drug (0.0027) was 3 times better than gentamicin's (0.0075). ConclusionsAdministration of intracameral cefuroxime resulted more effective and less expensive in preventing endophthalmitis after cataract surgery.