Posters

Novel & innovative study on new drug delivery system intra-operatively to prevent nocardia species induced endophthalmitis

Poster Details

First Author: A.Kamath INDIA

Co Author(s):    J. Reddy   D. Bhosale   A. Pai   M. Kamath   S. K S        

Abstract Details

Purpose:

Nocardia is a very common cause of endophthalmitis in the southern Indian state of Tamil Nadu ranging from 0.3% to 4.2%. It is an aggressive disease with poor prognosis. Therefore we conducted a study where we used antibiotics in the irrigation drip of BSS during the surgery to prophylactically study the occurance of nocardia endophthalmitis and study any toxic effects of the antibiotics used.

Setting:

Tertiary referral hospital, prospective analysis of 6 months study period from july to December-2018 of 100 patients undergoing phacoemulsificatin. Main outcome measures-pre-opertaive and post-operative specular counts & macular Ocular Coherence Tomography(OCT).

Methods:

100 patients being operated for phacoemulsification surgery were randomly assigned to 2 groups. First group of 50 patients had antibiotic amikacin of dosage 12.5mg in the 500ml (0.025mg per ml of balanced saline solution(BSS) drip through the course of the surgery. The second control group had no amikacin antibiotic in the drip during the procedure. Phacoemulsification surgery was performed on all 100 patients by a single surgeon and was uneventful. Pre-operative and post-operative specular counts and macular OCT were taken and recorded of all the patients respectively and data obtained were statistically compared and interpreted

Results:

'- The specular endothelial loss (p=1.137) & macular OCT (p=0.957) readings of patients irrespective of the presence or absence of antibiotic amikacin was insignificant and negligible. More importantly there was nil incidence of nocardia endophthalmitis among 33465 cataract surgeries operated in the annual year of 2018 from when we started using antibiotic amikacin in the balance saline solution. It was as high as 50% till we started using amikacin drug in the BSS solution.

Conclusions:

By using antibiotic amikacin in the balanced saline drip during the course of the surgery our study showed a zero infection rate by nocardia endophthalmitis. Also there was no intra-ocular side effects like corneal endothelial toxicity and macular toxicity on using the antibiotic amikacin in the irrigation drip. Hence we suggest the usage of amikacin antibiotic in the balanced saline solution in places where mass community cataract surgeries and in places where nocardia endophthalmitis is prevalant. we have started following this practise and having excellent results.

Financial Disclosure:

None