The following is a summary of “Effect of prophylactic topical antibiotics on rates of infectious complications after strabismus surgery: a large database study,” published in the December 2024 issue of Ophthalmology by Binczyk et al. 

Researchers conducted a retrospective study to analyze the effect of postoperative topical antibiotics on the rate of surgical site infections after strabismus surgery.  

They used data from TriNetX, an international electronic health record registry with over 130 million patients. Patients who underwent strabismus surgery in the past 20 years were identified using CPT codes. The study group included those prescribed postoperative topical antibiotics, while the control group consisted of those who were not. Eye antibiotic prescriptions were identified using RxNorm codes, and surgical site infections were identified using ICD-10 codes. Patient demographics, including age, sex, and race, were recorded if available in the records. Analysis was performed using the measures of association feature in TriNetX.  

The results showed 84,052 patients underwent strabismus surgery, with 38,484 (46%) receiving postoperative topical antibiotics, of the patients, 70% were White and 10% were Black, with a slight female preponderance (51%). Endophthalmitis occurred in 16 patients (0.019%), orbital cellulitis in 24 (0.029%), and preseptal cellulitis in 55 (0.065%). No significant differences were found in the rates of endophthalmitis, orbital cellulitis, and preseptal cellulitis between the groups (P values 0.855, 0.684, and 0.925, respectively).  

Investigators concluded the prescription of prophylactic topical antibiotics did not demonstrate a reduction in surgical site infection rates after strabismus surgery while potentially causing distress, increasing costs, and contributing to antimicrobial resistance. 

Source: ajo.com/article/S0002-9394(24)00563-4/abstract