Antibiotic and anti-inflammatory prophylaxis in cataract surgery: Latin America and the Caribbean survey

Purpose: The purpose of this study was to evaluate current practice patterns of antibiotic and anti-inflammatory prophylaxis in cataract surgery in Latin America and the Caribbean. Design: The study design involves cross-sectional online survey. Methods: A link to an anonymous online survey consisting of 36 questions related to preoperative, perioperative, and postoperative antibiotic and anti-inflammatory prophylaxis was sent to ophthalmologists in our contact database who perform cataract surgery in Latin America and the Caribbean. Results: Responses were received from 407 cataract surgeons. Preoperative topical antibiotics were reported to be routinely prescribed by 45% of respondents and postoperatively by 99%. Routine intracameral (IC) antibiotic injection was reported by 51%, with moxifloxacin preferred by 84%. Reasons cited for not adopting injections included being unconvinced of the need (60%), mixing/compounding risk (26%), and cost (8%). Topical steroids were routinely prescribed by 96% of surgeons for the postoperative period, with 61% reporting using prednisolone. A nonsteroidal anti-inflammatory drug (NSAID) was routinely prescribed by 58% for the postoperative period. Nineteen percent of surgeons do not instruct patients to taper steroids, 47% instruct patients to taper topical antibiotics, and 29% NSAIDs (if prescribed). Routine corticosteroid injection at the conclusion of surgery was reported by 22%. Of these, 53% reported injecting in the subconjunctival space, 28% in the peribulbar region, and 19% in the anterior chamber. Conclusions: IC antibiotic prophylaxis was injected by 51% of surgeons; however, 99% also prescribed topical postoperative antibiotics. Ninety-six percent of respondents prescribed topical steroids postoperatively, 58% prescribed an NSAID, and 22% injected a steroidal anti-inflammatory at the conclusion of surgery.