[Prevention of bacterial endophthalmitis after cataract surgery in adults]

Technical progress in cataract surgery has led to the phacoemulsification of the eye lens by ultrasound followed by the intraocular lens implantation. In spite of rigorous preventive hygiene and sterilization measures taken before, during and after the operation, two clinical forms of endophthalmitis seriously threaten vision in the operated eye: externally induced endophthalmitis, specifically with pyocyanic bacillus, which often follows the irregular use of reuseable tubings and internally induced endophthalmitis due to the inevitable penetration during the intraocular operation of conjunctival micro-organisms especially staphylococci. A zero-risk level is non-existent and it would be unjust to hold the ophthalmologist responsible for it, when he has done everything possible to reduce the risk. The question of bacteriological examinations, the problem of antibioprophylaxis, and the danger of the reuseable tubings and of the ambulatory surgery, concerning at-risk patients, are discussed in this paper.