Sunday, April 6, 2008

Dr Peter Barry answers critics of ESCRS Endophthalmitis Study


Dr Peter Barry offered a spirited defence of the European Society of Cataract and Refractive Surgeons(ESCRS)Endophthalmitis study at an ASCRS Symposium today.

Dr Barry, who was part of the ESCRS team that took part in The Around The World in 90minutes symposium, was discussing antibiotic prophylaxis with a number of colleagues from the American Society of Cataract and Refractive Surgery(ASCRS) the Asian Pacific Association of Cataract and Refractive Surgeons (APACRS) and the Latin American Society of Cataract and Refractive Surgery (ALACSA/LASCRS).

From the results of the ESCRS study, Dr Barry and his co-investigators recommended that intracameral cefuroxime should be adopted worldwide. They said its use could save many thousands of eyes from potential blindness due to postoperative bacterial endophthalmitis following cataract surgery with IOL implantation.

The study enrolled 15,971 subjects from 23 clinics in nine European countries. The study found that the rate of endophthalmitis ranged from 0.05 per cent to 0.35 per cent

Dr Barry referred to criticism of the study in the American literature and particularly by the editor of Ophthalmology who had stated that this rate was "extraordinarily high".

"I would challenge that comment, " said Dr Barry, "because in Sweden where the standard practice is intracameral cefuroxime and no antibiotics, in their intracameral cefuroxime group their endophthalmitis rate is almost identical to our intracameral rate."

Dr Barry said the March 2007 editorial in Ophthalmology was titled Making The Most of the Evidence. "I would say to the editor of Ophthalmology that he is not making the most of the evidence, " said Dr Barry.

The other members of the ESCRS team who presented at the meeting were Dr Jose Guell (astigmatism) Dr Thomas Kohnen (IOL optics), Dr Simonetta Morselli (phaco fluidics), Dr Richard Packard (coaxial versus biaxial phacoemulsification) and Dr Paul Rosen (multifocal versus monovision).

ends

* A report on the ESCRS Endophthalmitis study will be featured in the May edition of EuroTimes. We are also preparing a podcast on the subject at www.escrs.org featuring an interview with Dr Peter Barry

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