Postoperative endophthalmitis associated with sutured versus unsutured clear corneal cataract incisions

To compare the incidence of postoperative endophthalmitis in clear corneal cataract surgeries performed with and without suture closure, antibiotics and povidone iodine.

Ambulatory surgery facility.

In a retrospective, consecutive case-series study, we reviewed the incidence of endophthalmitis in 815 consecutive eyes that underwent cataract surgery by a single surgeon over a 5-year period (379 unsutured and 436 sutured, 294 without and 521 with antibiotic drops in the immediate postoperative period, and 247 without and 568 with povidone iodine before patching).

There were five cases of culture-positive postoperative endophthalmitis in the unsutured group and none in the sutured group (p = 0.022). Although patients in these two groups received routine preoperative antibiotic and povidone-iodine drops, those in whom antibiotic eye drops were not initiated until the day after surgery (p = 0.006) and those who did not receive 5% povidone-iodine drops immediately after wound closure (p = 0.031), had a higher incidence of endophthalmitis.

Results suggest that by suturing the corneal incisions, by initiating antibiotic eye drops within the first 24 h of surgery and by instilling povidone-iodine drops after closure, the incidence of endophthalmitis after cataract surgery could possibly be reduced.