Effectiveness and Safety of an

Intracameral Injection of Cefuroxime

for the Prevention of
Endophthalmitis After Cataract
Surgery With or Without
Perioperative Capsular Rupture
 Pendahuluan

Meski operasi katarak terbukti sangat efektif dan relatif

Aman, komplikasi bedah masih menjadi sumber morbiditas
terbesar sebagai akibat dari tingginya beban kasus dan
meningkatnya jumlah operasi katarak

Komplikasi terparah yang ditimbyulkan adalah ablasio

retina, edema makula kisitk (CME) dan Endoftalmitis
Faktor risiko POE termasuk usia yang lebih tua (85 tahun), jenis
kelamin laki-laki, komplikasi perioperatif, dan corneal clear incision
2 .
Insidensi kejadian POE berkisar antara 0,04% sampai 0,8%
 Metode

Data dikumpulkan dari Program de Mdicalisation des

Data Source Systmes d'Informasi (PMSI) dan dari Analisis
ExtractionRecherches pourun Suivi Mdico-Economique

Karakterisitk Data untuk semua pasien berusia 40 tahun atau lebih

Pengambilan yang dialaminya operasi katarak di Perancis (65 juta
jiwa) antara Januari 2010 dan Oktober 2014
data

3
 Metode

Analisa Statistik
Untuk menilai efek cefuroxime pada
POE dan keamanan pada retina,
Kami menghitung variabel dan Semua analisis melibatkan
membaginya menjadi 4 kelas: penggunaan SAS versi 9.4 (SAS
Pasien dengan ruptur kapsul yang tidak Institute Inc) dan dilakukan di
menerima injeksi cefuroxime intrakameral Departemen Biostatistik,
Pasien dengan ruptur kapsul dan mendapat Epidemiologi, dan Penelitian Klinis di
injeksi cefuroxime intrakamera
University of Montpellier, Montpellier,
Pasien tanpa ruptur kapsul yang tidak
menerima suntikan cefuroxime Perancis
Pasien tanpa adanya ruptur kapsul yang
mendapat injeksi cefuroxime intrakamera
4
 Hasil

Efektivitas

Untuk penderita ruptur kapsul

posterior, kejadian POE lebih rendah
setelah mereka menerima suntikan
cefuroxime daripada bila tidak (0,37%
vs 0,51%, masing-masing [P = .001])
Untuk mata tanpa ruptur kapsul, efek
penggunaan atau penggunaan
cefuroxime pada kejadian CME tidak
diidentifikasi (0,72% vs 0,84%,
masing-masing [P = .80]), juga tidak
berpengaruh terhadap mata dengan
kapsular pecah (5,6% vs 7,3%,
masing-masing [P = .12]).
5
Metode

6
 Diskusi

Terdapat
peningkatan Faktor risiko Suntikan cefuroxime
insidensi POE terjadinya POE: menurunkan risiko
sebesar 50% dalam perioperatif ruptur POE untuk pasien
waktu 5 tahun kapsul, ekstraksi dengan atau tanpa
terakhir sedangkan ekstrasapsular, tidak pecahnya kapsul
penggunaan digunakan dan tidak terkait
cefuroxime cefuroxime, dan dengan peningkatan
meningkat dari 11% jenis kelamin laki- kejadian CME
menjadi 79% selama laki. pascaoperasi
periode yang sama.

7
 Diskusi

Di Perancis, penggunaan
cefuroxime relatif rendah
Pada tahun 2014 di
pada tahun 2010 dan
observatrium praktik
2011 (masing-masing
katarak eropa, 82% ahli Pada penelitian ini
11,1% dan 14,4%),
bedah mengatakan didapatkan bahwa,
kemudian meningkat
bahwa penting untuk penggunaan cefuroxime
hingga 79,1% pada tahun
memiliki antibiotik dikaitkan dengan
2014, mungkin karena
spektrum luas yang penurunan risiko POE
rekomendasi pedoman
tersedia secara komersial sebesar 39%
dinas kesehatan
untuk injeksi langsung di
pemerintah yang
intrakamera
dikeluarkan pada tahun
2011

8
 Data ini menunjukkan bahwa,
dalam praktik rutin, suntikan
cefuroxime intrakameral pada
akhir operasi katarak dikaitkan
dengan risiko POE yang lebih
rendah dan aman untuk pasien
dengan atau tanpa ruptur kapsul
perioperatif.

9
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