Prevention of endophthalmitis

To report the incidence of postoperative endophthalmitis in a series of patients who had cataract surgery with intraocular lens (IOL) implantation and to apply guidelines toward the prevention of postoperative endophthalmitis.

The Buzard Eye Institute for Corneal, Refractive and Cataract Surgery, Las Vegas, Nevada, USA.

In this prospective institutional study, 5,131 cataract surgery cases with IOL implantation were performed from 1998 to 2002 by 1 surgeon at a single institute. The surgeon used a blue-line incision at the superior location, povidone- iodine prophylaxis, and postoperative injection of subconjunctival antibiotics. The incidence of endophthalmitis in the study was compared with the general incidence in the United States (range 0.07% to 0.13%) and in published studies (range 0.02% to 0.57%).

The 5,131 cases were followed for a mean of 2 years (range 3 months to 4 years). The mean patient age was 69.6 years +/- 10.9 (SD). No case of endophthalmitis occurred. The zero incidence of endophthalmitis was below the general incidence in the United States and in published studies.

The findings suggest that the absence of postoperative endophthalmitis may be related to 4 factors: povidone-iodine prophylaxis, meticulous draping of the eyes, operative technique (blue-line incision), and postoperative injection of subconjunctival antibiotics.