PURPOSE To analyze the posterior capsule rupture (PCR) rates among staff and trainee cataract surgeons, and the postoperative endophthalmitis (POE) rates in uncomplicated and complicated eyes both with and without intracameral moxifloxacin prophylaxis (ICMP). SETTING Ten regional Aravind Eye Hospitals in India. DESIGN Retrospective multicenter clinical registry within a single hospital network. METHODS POE rates with and without ICMP were statistically compared for all eyes and separately for trainees versus staff, for phacoemulsification versus manual small-incision cataract surgery (M-SICS), and for a subgroup of eyes complicated by PCR or requiring secondary surgery. RESULTS All cataract surgeries (2 062 643) performed during the 8-year period from 2011 to 2018 at the 10 regional Aravind Eye hospitals were included in the analysis. With ICMP, the overall POE rate declined from 692 (0.07%) of 993 009 eyes to 185 (0.02%) of 1 069 634 eyes (P < .001). This was independently significant for phacoemulsification and for M-SICS (P < .001). The overall PCR rate was 28 352 (1.37%) of 2 062 643 eyes, and it was statistically higher for trainees irrespective of surgical method (P < .001). Both staff and trainee surgeons had higher PCR rates with phacoemulsification than with M-SICS (P < .001). Absent ICMP, PCR increased the overall POE rate by more than 7-fold to 63 (0.43%) of 14 505 eyes. ICMP reduced the POE rate after PCR to 25 (0.18%) of 13 847 eyes (P = .002). This ICMP benefit was separately significant for both M-SICS (0.54% vs 0.26%, P = .01) and phacoemulsification (0.29% vs 0.06%, P = .005). The POE rate was especially high after secondary IOL implantation (0.90% without ICMP vs 0.34% with ICMP; P = .10). CONCLUSIONS ICMP reduced the POE rate overall, with phacoemulsification, with M-SICS, and in eyes with PCR.

中文翻译：

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伴有或不伴有手术并发症的眼中使用前房内莫西沙星减少眼内炎：连续2百万例白内障手术的结果。

目的分析白内障手术医生和实习生白内障手术后囊破裂（PCR）的率，以及在无或没有房室内莫西沙星预防（ICMP）的情况下，单纯眼和复杂眼的术后眼内炎（POE）率。在印度设置十家地区Aravind眼科医院。设计在单个医院网络内进行回顾性多中心临床注册。方法统计比较所有眼睛的有或没有ICMP的POE率，分别比较受训者与工作人员，超声乳化术与人工小切口白内障手术（M-SICS），以及因PCR或需要二次手术而引起的亚组眼睛。结果分析纳入了2011年至2018年这8年间在10家地区Aravind Eye医院进行的所有白内障手术（2 062 643）。使用ICMP时，总体POE率从993009眼的692（0.07％）下降到1069634眼的185（0.02％）（P <.001）。这对于超声乳化术和M-SICS具有独立意义（P <.001）。总体PCR率为2 062 643眼的28 352（1.37％），与受训者相比，统计学上更高，与手术方法无关（P <.001）。与M-SICS相比，白内障超声乳化术的工作人员和受训医生均具有更高的PCR率（P <.001）。如果没有ICMP，PCR可使14 505眼的总POE率增加7倍以上，达到63眼（0.43％）。ICMP将PCR后的POE率降低至13847眼的25（0.18％）（P = .002）。对于M-SICS（0.54％vs 0.26％，P = .01）和超声乳化（0.29％vs 0.06％，P = .005）而言，ICMP的这种好处分别是显着的。二次IOL植入后POE率特别高（0。不使用ICMP时为90％，使用ICMP时为0.34％；P = 0.10）。结论ICMP可以通过超声乳化，M-SICS和PCR降低总体POE率。