No intracameral antibiotic regimen beat another in nearly a million cataract operations

The edition in brief

The Swedish National Cataract Register recorded 131 cases of endophthalmitis in 979,534 operations from 2018 to 2024, an incidence of 0.013%. Rates were 0.017% with intracameral cefuroxime alone, 0.011% with cefuroxime plus ampicillin and 0.010% with moxifloxacin, with no regimen significantly better; enterococcal infections were commoner with cefuroxime alone. Immediate sequential bilateral surgery was not associated with more endophthalmitis. The practical message is to use an intracameral antibiotic every time; the choice of agent matters less. An Indian tertiary centre described 20 eyes burned by carbide guns during Diwali, mostly young men with grade III injuries; after irrigation, medical therapy and early amniotic membrane grafting, all eyes epithelialised and mean acuity improved from logMAR 1.77 to 0.77 at three months. A one-year interim analysis of a Chinese trial in 194 children found a multipoint defocus spectacle lens comparable to a highly aspherical lenslet design in slowing myopia. The FDA lists a supplement to Sandoz's generic tafluprost application, an administrative action. The pearl covers steroid-induced pressure rises.