Eyeworld

22 | EYEWORLD | SPRING 2026 ASCRS NEWS EYEWORLD JOURNAL CLUB by Ethan Adre, MD, Deanna Dang, MD, Ryan Emmert, DO, Preston O'Brien, DO, Tyler Pfister, MD, Anushka Raj, MD, Jibran Sharieff, MD, Nitish Sood, MD, Megan Sweeney, MD, Dean McGee Eye Institute ophthalmology residents, Andrew Melson, MD, Resi- dency Program Director analyzed their effect on POE rates in cataract surgeries with intraoperative PCR. PCR cas- es represent a distinct, higher-risk subgroup in which ICA efficacy may differ. Hence, this systematic review and meta-analysis aims to address this knowledge gap and better inform clinical treatment strategies. Methods A systematic review and meta-analysis were conducted based on available studies published up to May 21, 2024, on PubMed, Embase, and Cochrane CENTRAL. There were no language or publication year restrictions. Eligible stud- ies needed to be categorized as a randomized controlled trial or an observational study, report the incidence of endophthalmitis in patients with posterior capsular rupture during cataract surgery, and compare prophylactic intracam- eral antibiotics to no intracameral antibiotics. Cataract extraction via manual small incision cataract surgery or phacoemulsification was in- cluded. Animal studies, case reports, single-arm studies, and review articles were excluded. Each selected study underwent evaluation by two independent reviewers. The authors of included studies were contacted to obtain data regarding the baseline characteristics, incidence of endophthalmitis, and any incomplete or unclear data. Risk of bias within individual studies and publication bias were assessed by two authors independently and a funnel plot, respectively. EyeWorld Journal Club review Make a donation to the ASCRS Foundation and Operation Sight In addition to participating in onsite opportuni- ties and events at the ASCRS Annual Meeting, consider a donation to the ASCRS Foundation. With your support, we can help provide critical care to U.S. residents who are uninsured or under-insured—offering them the chance for a better life, free from the limitations of vision loss. Your donation, no matter the size, makes a world of difference. Whether you give today or choose to include ASCRS in your donor-advised fund (DAF) or planned giving, your generosity directly helps those who need it most. Make a tax-deductible donation today and give the gift of sight—an enduring gift that will transform lives for years to come. We appreciate your continued support. continued from page 20 Review of "Use of intracameral antibiotics prophylaxis in patients with posterior capsular rupture during cataract surgery: a systematic review and meta-analysis" Introduction C ataract surgery is the most common ophthalmic surgery and is among the most effective and safest operations worldwide; however, rare complica- tions may result in devastating visual outcomes. One particularly feared complication is acute postoperative endophthalmitis (POE), which results in rapid, profound vision loss. Large-scale databases such as the Intelligent Research in Sight (IRIS) Registry report that, as of 2013–2017, 0.04% of cataract surgeries performed in the U.S. resulted in POE. 1 Posteri- or capsular rupture (PCR) has been shown to in- crease this risk by more than 6-fold and is likely due to factors such as prolonged operative time and vitreous exposure. 2 Given the high global volume of cataract surgeries, even small im- provements in POE incidence may translate into clinically significant prevention opportunities, particularly in cases such as those with PCR. In recent years, administration of intraca- meral antibiotics (ICA) has been widely adopt- ed by ophthalmologists due to their ability to decrease the risk of POE; however, none of the studies demonstrating their efficacy have ever Andrew Melson, MD Residency Program Director Dean McGee Eye Institute Oklahoma City, Oklahoma

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