No intracameral antibiotic regimen stood out across nearly a million Swedish cataract operations

The edition in brief

The Swedish National Cataract Register recorded 131 cases of endophthalmitis in 979,534 operations between 2018 and 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; no regimen was significantly better. Enterococcal infection was more frequent with cefuroxime, and moxifloxacin cases more often regained 20/40 vision. The choice of agent matters less than giving one. An Indian tertiary centre treated 20 eyes burned by carbide guns during Diwali with irrigation, medical therapy and early overlay amniotic membrane; all epithelialised, vision improved from logMAR 1.77 to 0.77 at three months, and the one eye that presented late was lost. In 180 glaucoma eyes followed for five years, OCT angiography vessel density flagged progression a mean 2.3 years before visual fields, with somewhat lower specificity than OCT. The FDA recorded a supplement to Sandoz's generic tafluprost application, an administrative action. The pearl: irrigate a chemical eye injury before anything else.