Efficacy of intracameral and subconjunctival cefuroxime in preventing endophthalmitis after cataract surgery

PURPOSE: To compare the efficacy of intracameral cefuroxime versus subconjunctival cefuroxime in reducing the rate of endophthalmitis after cataract surgery. SETTING: Single-specialty eye hospital, Sunderland, United Kingdom. METHODS: A retrospective analysis of all presumed infectious endophthalmitis cases from January 1, 2000, to December 31, 2006 was performed. The rate of presumed infectious endophthalmitis in patients receiving subconjunctival cefuroxime was compared with those receiving intracameral cefuroxime at the end of surgery. RESULTS: This study included 36 743 phacoemulsification cataract procedures. The mean rate of presumed infectious endophthalmitis was 0.95 per 1000 cases. The incidence of endophthalmitis was higher in the subconjunctival cefuroxime group than in the intracameral cefuroxime group; the difference was statistically significant with an odds ratio of 3.01 (95% confidence interval, 1.37-6.63). CONCLUSION: Intracameral cefuroxime was a safe alternative to subconjunctival cefuroxime and led to a lower rate of endophthalmitis.