Okayama University


Okayama University Medical Research Updates (OU-MRU) Vol.111

March 03, 2023

Source: Okayama University (JAPAN), Public Relations Division
For immediate release: 03 March 2023
Okayama University research: Antibiotics use in cataract surgery

(Okayama, 03 March) In a study recently published in the International Journal of Environmental Research and Public Health, researchers from Okayama University make a question on the use of intravenous and oral antibiotics as a precautionary measure to prevent eye infections after cataract surgery.

Over the last decade antimicrobial resistance has emerged as an important global health concern. This is the resistance that microbes, mainly bacteria, develop to standard antibiotics due to the widespread and often redundant use of such drugs. The bacteria then stop responding to antibiotics used against them, potentially increasing the possibility of infection. An example of such routine use of antibiotics in Japan is during cataract procedures to prevent the risk of contracting eye infections during surgery. However, the effectiveness of these medications in this context is still uncertain. Now, a team led by Professor MATSUO Toshihiko (M.D.) at Okayama University has analyzed the outcomes of antibiotics routinely used with cataract procedures over the last six years.

The researchers gathered information on 2149 cataract surgeries performed and antibiotics given for surgical procedures performed by a surgeon at Ochiai Hospital in the Okayama prefecture from April 2016 to October 2022. Next, based on the patterns of intravenous and oral antibiotics administered around the procedure, five different stages were categorized over time. The dose of antibiotics decreased with each stage.

Stage 1 involved a dose of intravenous and oral antibiotics on surgery day followed by doses of the oral antibiotic for 2 days post surgery. Stage 2 involved doses of the oral antibiotic on and 2 days post surgery. Stage 3 involved a switch to a different oral antibiotic on and 2 days post surgery, whereas Stage 4 involved just one dose of it on the day of surgery. Finally, Stage 5 which was implemented in November 2021, involved no antibiotics on the day of or after surgery.

The incidence of postoperative eye infections and strains of bacteria found on the eye surface before surgeries were then examined in each stage. The researchers found no difference in species of bacteria found on the eye surface of patients between all five stages. Furthermore, no cases of eye infection post cataract surgery were found in any of the five stages. Thus, the eliminated use of intravenous and oral antibiotics with cataract surgery in Stage 5 showed no increased risk of eye infection.

The research team concludes that there is no evidence of either harm or risk in reduced and later no use of systemically given prophylactic antibiotics in cataract surgery as far as local precautionary measures are taken. As the common standard of the local precautionary measures in each stage, prophylactic antibiotic eye drops are given before and after the surgery, and the ocular surface during the surgery is frequently washed with disinfectants such as povidone iodine. Cataract surgery might be one potential channel to reduce the intravenous and oral administration of antibiotics as a redundant precautionary measure. Spreading this message across different institutions in Japan that follow this protocol for cataract surgeries might also help reduce the unwanted use of antibiotics.

Antibiotics and antimicrobial resistance: The World Health Organization published an action plan to mitigate antibiotic use across the globe in 2015. Antibiotics, traditionally used to fight bacterial infections, have often been used redundantly or without prescription across the globe. This has resulted in bacteria developing resistance to these standard antibiotics. These resistant bacteria are, in turn, much harder to fight. What’s more, bacteria are developing faster ways to bypass the effects of antibiotics making them even more difficult to combat.

Besides practicing good hygiene measures, the best way to fight this issue is to minimize the use of antibiotics unless necessary as deemed by a medical professional. Japan is one of the few countries to adopt antibiotic use as a routine supplement along with cataract surgery. Thus, the researchers aimed to investigate whether this use of antibiotics is effective or not.

Toshihiko Matsuo, Masahiro Iguchi, Noriyasu Morisato, Tatsuya Murasako, Hideharu Hagiya. Are Prophylactic Systemic Antibiotics Required in Patients with Cataract Surgery at Local Anesthesia? Int J Environ Res Public Health, 2022 Nov 27;19(23):15796.

Reference (Okayama Univ. e-Bulletin): Dr. MATSUO’s team
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OU-MRU Vol.53:Successful implantation and testing of retinal prosthesis in monkey eyes with retinal degeneration
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OU-MRU Vol.73:Primary intraocular lymphoma does not always spread to the central nervous system
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Correspondence to
Professor MATSUO Toshihiko, M.D., Ph.D.
Ophthalmology, Okayama University Hospital and
Graduate School of Interdisciplinary Science and Engineering
in Health Systems,
2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
E-mail: matsuot (a) cc.okayama-u.ac.jp
For inquiries, please contact us by replacing (a) with the @

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Okayama University Medical Research Updates (OU-MRU)
The whole volume : OU-MRU (1- )
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Vol.2:Ensuring a cool recovery from cardiac arrest
Vol.3:Organ regeneration research leaps forward
Vol.4:Cardiac mechanosensitive integrator
Vol.5:Cell injections get to the heart of congenital defects
Vol.6:Fourth key molecule identified in bone development
Vol.7:Anticancer virus solution provides an alternative to surgery
Vol.8:Light-responsive dye stimulates sight in genetically blind patients
Vol.9:Diabetes drug helps towards immunity against cancer
Vol.10:Enzyme-inhibitors treat drug-resistant epilepsy
Vol.11:Compound-protein combination shows promise for arthritis treatment
Vol.12:Molecular features of the circadian clock system in fruit flies
Vol.13:Peptide directs artificial tissue growth
Vol.14:Simplified boron compound may treat brain tumours
Vol.15:Metamaterial absorbers for infrared inspection technologies
Vol.16:Epigenetics research traces how crickets restore lost limbs
Vol.17:Cell research shows pathway for suppressing hepatitis B virus
Vol.18:Therapeutic protein targets liver disease
Vol.19:Study links signalling protein to osteoarthritis
Vol.20:Lack of enzyme promotes fatty liver disease in thin patients
Vol.21:Combined gene transduction and light therapy targets gastric cancer
Vol.22:Medical supportive device for hemodialysis catheter puncture
Vol.23:Development of low cost oral inactivated vaccines for dysentery
Vol.24:Sticky molecules to tackle obesity and diabetes
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Vol.26:Protein for preventing heart failure
Vol.27:Keeping cells in shape to fight sepsis
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Vol.30:Cancer stem cells’ role in tumor growth revealed
Vol.31:Prevention of RNA virus replication
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Vol.33:Attacking tumors from the inside
Vol.34:Novel mouse model for studying pancreatic cancer
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Vol.46:New method for suppressing lung cancer oncogene
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Vol.48:Nanotechnology-based approach to cancer virotherapy
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Vol.50:Iron removal as a potential cancer therapy
Vol.51:Potential of 3D nanoenvironments for experimental cancer
Vol.52:A protein found on the surface of cells plays an integral role in tumor growth and sustenance
Vol.53:Successful implantation and testing of retinal prosthesis in monkey eyes with retinal degeneration
Vol.54:Measuring ion concentration in solutions for clinical and environmental research
Vol.55:Diabetic kidney disease: new biomarkers improve the prediction of the renal prognosis
Vol.56:New device for assisting accurate hemodialysis catheter placement
Vol.57:Possible link between excess chewing muscle activity and dental disease
Vol.58:Insights into mechanisms governing the resistance to the anti-cancer medication cetuximab
Vol.59:Role of commensal flora in periodontal immune response investigated
Vol.60:Role of commensal microbiota in bone remodeling
Vol.61:Mechanical stress affects normal bone development
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Vol.63:Promising biomarker for vascular disease relapse revealed
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Vol.65:Game changer: How do bacteria play Tag ?
Vol.66:Is too much protein a bad thing?
Vol.67:Technology to rapidly detect cancer markers for cancer diagnosis
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Vol.69:Early gastric cancer endoscopic diagnosis system using artificial intelligence
Vol.70:Prosthetics for Retinal Stimulation
Vol.71:The nervous system can contribute to breast cancer progression
Vol.72:Synthetic compound provides fast screening for potential drugs
Vol.73:Primary intraocular lymphoma does not always spread to the central nervous system
Vol.74:Rising from the ashes—dead brain cells can be regenerated after traumatic injury
Vol.75:More than just daily supplements — herbal medicines can treat stomach disorders
Vol.76:The molecular pathogenesis of muscular dystrophy-associated cardiomyopathy
Vol.77:Green leafy vegetables contain a compound which can fight cancer cells
Vol.78:Disrupting blood supply to tumors as a new strategy to treat oral cancer
Vol.79:Novel blood-based markers to detect Alzheimer’s disease
Vol.80:A novel 3D cell culture model sheds light on the mechanisms driving fibrosis in pancreatic cancer
Vol.81:Innovative method for determining carcinogenicity of chemicals using iPS cells
Vol.82:Making memories — the workings of a neuron revealed
Vol.83:Skipping a beat — a novel method to study heart attacks
Vol.84:Friend to Foe—When Harmless Bacteria Turn Toxic
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Vol.86:Plates and belts — a toolkit to prevent accidental falls during invasive vascular proceduresa
Vol.87:Therapeutic potential of stem cells for treating neurodegenerative disease
Vol.88:Nanotechnology for making cancer drugs more accessible to the brain
Vol.89:Studying Parkinson’s disease with face-recognition software
Vol.90:High levels of television exposure affect visual acuity in children
Vol.91:Meeting high demand: Increasing the efficiency of antiviral drug production in bacteria
Vol.92:Numerical modelling to assist the development of a retinal prosthesis
Vol.93:Repurposing cancer drugs: An innovative therapeutic strategy to fight bone cancer
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Vol.110:Respiratory infections and asthma: The COVID-19 connection