Intrastromal Injection of Vancomycin in Clear Corneal Wound Seal Prophylaxis on Endophthalmitis

Regardless of wound construction technique, instrumentation used during the cataract procedure can contribute to poor incision apposition and seal. Dr. McDonald recommends the use of intrastromal injection of vancomycin to seal wounds and prevent endophthalmitis.

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Comments (8)

this can also be done with standard rycroft cannula viz a viz tuberculin needle. Also can use Cefuroxime instead of vancomycin. But this is just a little extra security - I would still be much happier using intracameral cefuroxime as per escrs study. I would add that this approach whether alone or in combination with intracameral injection has not been evaluated in a trial setting yet. Does it really add extra value or not ?

EY55DOC (8 months ago)

The potential pathogens are either inside de eye already, or outside (as normal flora) why intrastromal ?

ernesto987 (59 months ago)

I went to Dr. McDonald's ASCRS lecture last week, and he mentioned that the point of this is to 'tamponade' the incision closed with this injection. I was looking at the video to see if the needle goes above the incision path or to the side, but I can't tell. You don't go into the wound, as in hydrating the wound.

kg (61 months ago)

I use vigamox intracameral and to hydrate the incision / paracentesis. It works very well and leads to instant high levels that continue with the topical vigamox used post op.

drmargolis11 (61 months ago)

Is better using vancomicyn in endoftalmithis no to prevent it. Vigamox is good election and in this way no get more antiobiotic resistance.

fredy (61 months ago)

I'm gonna go with the intracameral technique, not liking this...

ZMario (62 months ago)

Could one do the same with Vigamox. I'm aware some are using a diluted Vigamox solution intracamerally at the end of the case. Could one also hydrate the wound with it? Never tried it, but I've often wondered if anyone has experience with it.

PosvarMD (62 months ago)

why a needle? why not a cannula in the wound like we do now with bss?

ranchump (62 months ago)