Extended Postoperative Ciprofloxacin Prophylaxis for Post-Phacoemulsification Endophthalmitis

Abstract Purpose: This study investigated the efficacy of extended oral ciprofloxacin prophylaxis in reducing the incidence of endophthalmitis after cataract surgery. Setting: Single-center study conducted at a tertiary health facility. Design: This was a retrospective observational study. Methods: This study was conducted on patients who underwent uncomplicated phacoemulsification surgery. Two cohorts were analyzed: one receiving oral ciprofloxacin twice daily for one week post-surgery and another not receiving ciprofloxacin. The patients who did not receive ciprofloxacin were operated on between June 2013 and October 2019, while the others underwent surgery between June 2011 and April 2021. Endophthalmitis incidence, patient demographics, and surgical variables were assessed between the two groups. Statistical analyses included chi-square tests, Fisher’s exact tests, logistic regression, and Kaplan‒Meier estimates. Results: Out of 1172 eyes (1015 patients), 548 received ciprofloxacin, and 624 did not. The ciprofloxacin group reported a 0% incidence of endophthalmitis compared to 0.8% in the non ciprofloxacin group. While the chi-square test revealed significant differences (p=0.036), Fisher’s exact test did not reach significance at values less than <0.05. The efficacy of oral ciprofloxacin in preventing endophthalmitis was 100%. The odds ratios for sex, age, and unilateral/bilateral surgery were not significant. Challenges in achieving statistical significance, attributable to zero events in the ciprofloxacin group, were acknowledged. Conclusion: Oral administration of two 750 mg tablets of ciprofloxacin per day for one week after phacoemulsification surgery is superior to a single intracameral antibiotic injection as an additional treatment.