***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: The incidence of bacterial endophthalmitis has been 3 - 6 % after cataract extraction in the eye camps of South India from 1961 - 75 . During this time 50 791 cases were operated using systemic and topical chloramphenicol prophylaxis .  This study evaluated the prophylactic intracameral injection of 50 microng of gentamicin in eye camp cataract extraction s. Only 6 of 1626 patients treated with intracameral gentamicin at operation developed bacterial endophthalmitis , an incidence of 0 - 37 % PURPOSE : To report results in the European Society of Cataract & Refractive Surgeons ( ESCRS ) multicenter study of the prophylaxis of endophthalmitis after cataract surgery . SETTING : Twenty‐four ophthalmology units and eye clinics in Austria , Belgium , Germany , Italy , Pol and , Portugal , Spain , Turkey , and the United Kingdom , with an administrative office in Irel and , coordinating center in Engl and , and data management and statistical unit in Scotl and . METHODS : This partially masked r and omized placebo‐controlled multinational clinical study to evaluate prospect ively the prophylactic effect of intracameral cefuroxime injection and /or perioperative levofloxacin eyedrops on the incidence of endophthalmitis after phacoemulsification cataract surgery began in September 2003 and was terminated early in January 2006 . The study used r and om allocation of patients in a 2 × 2 factorial design . RESULTS : By the end of 2005 , complete follow‐up records had been received for 13 698 study patients . Such a clear beneficial effect from the use of intracameral cefuroxime had been observed that it was agreed it would be unethical to continue the study and to wait for the completion of all follow‐up procedures before reporting this important result . If total reported cases of endophthalmitis are considered , the incidence rate observed in those treatment groups not receiving cefuroxime prophylaxis ( 23 cases in 6862 patients ) was almost 5 times as high ( odds ratio [ OR ] , 4.59 ; 95 % confidence interval [ CI ] , 1.74‐12.08 ; P = .002 ) as that in the groups receiving this treatment ( 5 cases in 6836 patients ) . If only cases proved to be due to infection are considered , the rate was more than 5 times as high ( OR , 5.32 ; 95 % CI , 1.55‐18.26 ; P = .008 ) in the treatment groups not receiving cefuroxime . Although the use of perioperative levofloxacin eyedrops as prophylaxis was also associated with a reduction in the observed incidence rate of postoperative endophthalmitis , this effect was smaller and was not statistically significant , whether total reported cases or only cases proven to be due to infection are used in calculating the rates . As not all follow‐up procedures are complete , it is possible that further cases of endophthalmitis may be reported ; however , it is not expected that this will alter the main conclusion . Nevertheless , it is anticipated that successful completion of follow‐up procedures in all patients will increase the total number in the study to approximately 16 000 . CONCLUSION : Intracameral cefuroxime administered at the time of surgery significantly reduced the risk for developing endophthalmitis after cataract surgery OBJECTIVE : To compare the efficacy and tolerability of a fixed combination of 0.3 % gatifloxacin and 1 % prednisolone ( Zypred ® ) versus the individual components used separately ( Zymar ® and Predfort ® ) for infection prophylaxis and inflammation control after cataract surgery with intraocular lens implantation . METHODS : A prospect i ve , r and omized , double-blind , parallel-group study of 108 patients who underwent phacoemulsification and intraocular lens implantation was conducted . After r and om assignment , 47 eyes received the fixed combination of topical 0.3 % gatifloxacin/1 % prednisolone drops , and 61 eyes received the same doses of the individual components as separate solutions four times a day for 15 days . Baseline and postoperative assessment s were made on postoperative days 1 , 7 , 15 , and 20 . RESULTS : All objective ( best corrected visual acuity , sign of active ocular inflammation , central and incisional corneal edema , the number of cells per high-power field in the anterior chamber , and intraocular pressure ) and subjective ( eye pain , photophobia , burning sensation , itching , and foreign body sensation ) criteria of efficacy were similar in both groups , with no significant differences . Group I included 47 eyes that received the fixed combination of gatifloxacin/prednisolone acetate eye drops and a placebo eye drop solution . Group II included 61 eyes that were treated with 0.3 % gatifloxacin and 1 % prednisolone acetate eye drops separately . The intraocular pressure was slightly higher in Group II ( p<0.05 ) . CONCLUSION : Treatment with the fixed-dose combination of gatifloxacin/prednisolone eye drops was as effective as the non-fixed combination in preventing infection and controlling inflammation after phacoemulsification and intraocular lens implantation IMPORTANCE Postoperative endophthalmitis ( POE ) often results in severe visual impairment . In clinical studies , an intracameral cefuroxime injection at the end of surgery was found to be effective at reducing the incidence of POE . Two important issues are the retinal safety of cefuroxime and its use for patients with perioperative capsular rupture where the risk of POE is dramatically increased . OBJECTIVE To assess the effectiveness and retinal safety of an intracameral injection of cefuroxime sodium for the prevention of POE and its possible use in cases of a perioperative capsular rupture of the lens . DESIGN , SETTING , AND PARTICIPANTS Population -based cohort study of patients 40 years of age or older who underwent cataract surgery at 1 of 1546 French health care facilities , public or private , and whose medical records were obtained from the national administrative data base . Data analyses were performed between March and November 2015 . MAIN OUTCOMES AND MEASURES The effectiveness and safety of the prophylactic injection of cefuroxime as measured by the incidence of POE and cystoid macular edema . RESULTS From January 2010 to October 2014 , a total of 3 351 401 eyes of 2 434 008 patients 40 years of age or older ( 58.9 % were women , and the mean [ SD ] age was 73.9 [ 9.5 ] years ) underwent cataract surgery ; 1941 patients ( 0.08 % ) developed POE during the 6 weeks after cataract surgery . The incidence of POE after cataract surgery decreased over the course of the study ( 0.11 % , 0.09 % , 0.08 % , 0.06 % , and 0.05 % in 2010 , 2011 , 2012 , 2013 , and 2014 , respectively [ P = .001 for trend ] ) as the use of cefuroxime prophylactic injections increased ( 11.1 % , 14.4 % , 32.8 % , 64.8 % , and 79.1 % in 2010 , 2011 , 2012 , 2013 , and 2014 , respectively [ P = .001 for trend ] ) . After multivariate adjustment , the risk of POE was reduced with the use of cefuroxime ( odds ratio , 0.61 [ 95 % CI , 0.56 - 0.68 ] ) . The retinal safety of an injection of cefuroxime  , which was assessed by multiadjusted odds of retinal cystoid macular edema , was not increased for patients receiving cefuroxime injections ( odds ratio , 0.86 [ 95 % CI , 0.71 - 1.05 ] ) . For patients with a perioperative capsular rupture of  the lens ( the major risk factor for POE ) , the incidence of POE was lower for those who received an injection of cefuroxime than for those who did not ( 0.37 % vs 0.51 % , respectively [ P = .001 ] ) , whereas an increased risk of cystoid macular edema was not identified for those who received or did not receive an injection of cefuroxime ( 5.6 % vs 7.3 % , respectively [ P = .12 ] ) . CONCLUSIONS AND RELEVANCE These data suggest that , in routine practice , the intracameral injection of cefuroxime at the conclusion of cataract surgery is associated with a lower risk of POE and is safe for patients with or without a perioperative capsular rupture . While these data might be used to support the consideration of its routine use to prevent POE , in the absence of a r and omized clinical trial , they can not prove a direct cause- and -effect relationship between the injection of cefuroxime and POE PURPOSE To compare intraoperative injection of triamcinolone and ciprofloxacin in a controlled-release system ( DuoCat ) with prednisolone and ciprofloxacin eye drops after cataract surgery . METHODS In this r and omized , double-masked , controlled trial , a total of 135 patients undergoing cataract surgery were r and omly allocated to two groups : 67 patients treated after surgery with prednisolone 1 % and ciprofloxacin 3 % eye drops four times daily ( week 1 ) , three times daily ( week 2 ) , twice daily ( week 3 ) , and once daily ( week 4 ) and 0.3 % ciprofloxacin drops four times daily ( weeks 1 and 2 ) , and 68 patients treated at the end of surgery with a sub-Tenon 's injection of 25 mg triamcinolone and 2 mg ciprofloxacin in biodegradable microspheres . The patients were examined on postoperative days 1 , 3 , 7 , 14 , and 28 . The main outcome measures were postoperative anterior chamber cell and flare , intraocular pressure ( IOP ) , lack of anti-inflammatory response , and presence of infection . RESULTS No significant differences were observed between the groups in anterior chamber cell ( P > 0.14 ) and flare ( P > 0.02 ) at any postoperative visits . The mean ( 99 % confidence interval ) differences in IOP between the prednisolone and triamcinolone groups on days 1 , 3 , 7 , 14 , and 28 were -0.4 mm Hg ( -2.1 to 1.3 ) , 0.0 mm Hg ( -1.4 to 1.3 ) , 0.0 mm Hg ( -1.1 to 1.1 ) , -0.2 mm Hg ( -1.1 to 0.8 ) , and -0.1 mm Hg ( -1.1 to 0.9 ) , respectively . No patient had a postoperative infection . CONCLUSIONS One injection of DuoCat had a therapeutic response and ocular tolerance that were equivalent to conventional eye drops in controlling inflammation after cataract surgery . ( Clinical Trials.gov number , NCT00431028 . ) Purpose To report the nationwide incidence and risk factors for endophthalmitis after cataract surgery in Sweden . Setting Swedish National Cataract Register containing reports on cataract operations from all Swedish ophthalmic surgical units . Design Prospect i ve epidemiologic study . Methods Endophthalmitis case reports were collected from 2005 through 2010 . Case and control parameters pertaining to patient characteristics and surgical technique were generated from the data base . In addition , information from annual surveys regarding the topical prophylactic protocol was analyzed . Results The reports showed 135 endophthalmitis cases in 464 996 operations , equaling an incidence of 0.029 % . Patient age over 85 years , perioperative communication with the vitreous and , above all , nonuse of intracameral cefuroxime showed a statistically significant association with endophthalmitis in the logistic regression . Short‐term topical antibiotics given as add‐on prophylaxis to the intracameral regimen before , after , or before and after the operation did not confer a clear‐cut benefit . Groups with topical treatment were small , comprising 14 % of the sample . Conclusions The incidence of endophthalmitis after cataract surgery in Sweden is declining , which appears to be explained by a fall in the frequency of major risk factors . Operating earlier in the cataract course , avoiding capsule breakage , and giving intracameral antibiotics universally should further reduce the endophthalmitis rate . Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned Purpose To compare two different postcataract surgery antibiotic/steroid therapeutic combinations , for clinical results as well as patient satisfaction . Methods Prospect i ve r and omized clinical trial of patients with bilateral operative cataract . Postoperatively , for 15 days one eye was r and omly assigned to therapy with the combination chloramphenicol 0.25%-betamethasone 0.13 % gel three times a day ( Group 1 ) and the other to the combination tobramycin 0.3%-dexamethasone 0.1 % eyedro 
    Output:
    
High-certainty evidence shows that injection with cefuroxime with or without topical levofloxacin lowers the chance of endophthalmitis after surgery , and there is moderate-certainty evidence to suggest that using antibiotic eye drops in addition to antibiotic injection probably lowers the chance of endophthalmitis compared with using injections or eye drops alone .