Original article : Clinical science
Japanese Survey of Perioperative Disinfection and Antibiotic Prophylaxis in Cataract Surgery
Kazuki Matsuura1, Takeshi Miyamoto2, Shigeto Tanaka3, Masafumi Uematsu4, Takafumi Mori5, Chikako Suto6, Fumie Takenobu7, Norihito Gotoh8, Shinji Ohkubo9, Masaki Tanito10, Masashi Kakinoki11, Takeshi Ohguchi12, Yusuke Saeki13, Yoshitsugu Inoue7
1 Department of Ophthalmology, Nojima Hospital
2 Department of Ophthalmology, Wakayama Medical University Kihoku Hospital
3 Department of Ophthalmology, Kagawa Prefectural Central Hospital
4 Department of Ophthalmology, Nagasaki University School of Medicine
5 Department of Ophthalmology, Fukushima Medical University
6 Department of Ophthalmology, Tokyo Women's Medical University
7 Divison of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University
8 Department of Ophthalmology, Dokkyo Medical University
9 Department of Ophthalmology and Visual Science, Kanazawa University Graduate School of Medical Science
10 Division of Ophthalmology, Matsue Red Cross Hospital
11 Department of Ophthalmology, Shiga University of Medical Science
12 Department of Ophthalmology, Hokkaido University Graduate School of Medicine
13 Department of Ophthalmology, School of Medicine, Fukuoka University
Purpose: To elucidate Japanese trends for perioperative disinfection and antibiotic selection during cataract surgeries.
Methods: Cataract surgeons in 12 regions in Japan were interviewed in March, 2016 about their use of perioperative iodine and antibiotic prophylaxis.
Results: We surveyed 825 surgeons, of which 544 (66%) responded. Most of the surgeons used iodine compounds before surgery for periocular skin disinfection (97%) or conjunctival disinfection (93%). Thirty four percent of surgeons used iodine disinfection several times intraoperatively. Preoperative antibiotic eye drops were used by 98% and postoperative antibiotic eye drops by 100% of surgeons, most of whom used fluoroquinolones. Antibiotics were added to an irrigation bottle by 102 surgeons (19%), 80 (78%) of whom used either imipenem or cephems. Subconjunctival antibiotic injections were used by 131 surgeons(24%), 101 (77%) of whom used aminoglycosides. Many surgeons reported the use of antibiotic ointments (78%), and intracameral antibiotics (7%), most of whom used fluoroquinolones. Total patients were 183432, and infectious endopthalmitis was reported in 21 cases (0.01%). Surgeons employed intracameral antibiotic injections in 14989 cases but reported no incidents of endophthalmitis.
Conclusions: Iodine compounds are commonly used preoperatively, and intraoperative iodine seems to be gaining popularity. Choice of drugs depends on administration methods.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 121: 521-528, 2017.
Key words
Cataract surgery, Endophthamlitis prophylaxis, Povidone iodine, Japan
Reprint requests to
Kazuki Matsuura, M.D. Department of Ophthalmology, Nojima Hospital. 2714-1 Sesakimachi, Kurayoshi-shi, Tottori-ken 682-0863, Japan
Received: 19 August 2016. Accepted in revised form: 19 February 2017.
Nihon Ganka Gakkai Zasshi
121: 521-528,2017
