ABSTRACT NUMBER - S2405

A CLINICAL AUDIT OF A NOVEL POSTOPERATIVE DROP REGIME FOLLOWING ROUTINE CATARACT SURGERY


Peter Macken1, Con Petsoglou2

Meeting:  2018 RANZCO


SESSION INFORMATION

Date:      -

Session Title: FREE PAPERS: Rapid Fire Presentations – CPD Audits

Session Time:      -

Purpose: The cessation of topical antibiotic pro- phylaxis has been reported to not increase rates of postoperative endophthalmitis (POE), when intra- cameral antibiotics are also used. Further, topical Chloramphenicol does not achieve effective ante- rior chamber concentrations against common POE. Our practice ceased topical Chloramphenicol and commenced topical nepafenac ophthalmic suspension 0.3% in July 2017 after cataract sur- gery at one hospital. Topical NSAIDS are used as prophylaxis against postoperative cystoid macular oedema.
Benchmarking/Standard: The incidence of POE has been reported to be in the range of 0.03% to 0.3% based on various studies. Clinical postopera- tive cystoid macular oedema (PCMO) has a reported incidence rate of 1-2%.
Methods: A consecutive series of 692 cases of cata- ract surgery performed at one hospital by the authors, was retrospectively reviewed. All cases had intracameral Cefazolin 2mg in 0.2mL, as antibiotic prophylaxis. Postoperatively g.Pred Forte TID (pred- nisolone acetate 1%, phenylephrine HCL 0.12%) and g.Ilevro NOCTE (nepafenac ophthalmic suspen- sion 0.3%) for 4 weeks was used. Preoperative and postoperative OCTs of foveal thickness were obtained on a subset of patients.
Results: Only one case of POE (0.14%) was observed during the period of review. This case was successfully treated with no loss of vision. As this case occurred on day 2 postoperatively, it was prob- ably not influenced by lack of Chloramphenicol. The low rate of POE is consistent with reported bench- mark standards. There was no increase in PCMO observed.
Conclusions: A simplified postoperative drop regime using only Pred Forte and Ilevro is recommended.

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