Intraoperative cefuroxime administration to prevent endophthalmitis in cataract surgery: a Polish perspective

Abstract

Cataract surgery is among the most common procedures performed in Europe and worldwide. Significant progress has been observed over the recent years, with improvements in the safety and health-related outcomes of the intervention. Nevertheless, cataract surgery is associated with complications, with endophthalmitis being one of the most severe. Cefuroxime, a second-generation cephalosporin, was the first antibiotic applied intraoperatively into the anterior chamber, to prevent endophthalmitis. In contrast to antibiotics administered in drops, the injection of an antibiotic into the anterior chamber of the eye at the end of the operation allows to achieve the drug concentration necessary for effective eradication of microorganisms. The article discusses the epidemiology of endophthalmitis and the current Polish guidelines for endophthalmitis prophylaxis during cataract surgery. Key results for cefuroxime efficacy from a randomized controlled clinical trial and observational studies about the effectiveness of the antibiotic in real-world clinical practice are cited. Recent data from the National Health Fund of Poland on active monitoring of cataract operations in Poland, including their quality, are presented. The paper also reports the cost-effectiveness of the use of cefuroxime (Aprokam®) for anterior chamber injections in Poland in the prophylaxis of endophthalmitis after cataract surgery.