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The Incidence of Postoperative Endophthalmitis Before and After a Revised Preoperative Surgical Site Preparation
Rachel P W Kwok1, Wilson W K Yip, Vishal Jhanji
1From the *Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong; †Prince of Wales Hospital; and ‡Alice Ho Miu Ling Nethersole Hospital, Shatin, Hong Kong.
Purpose:
To compare the incidence of postoperative endophthalmitis before and after the implementation of a preoperative surgical site preparation protocol for cataract surgery.
Design:
Retrospective cohort study.
Methods:
Records of patients with postoperative endophthalmitis between January 2006 and August 2013 were reviewed. A revised protocol implemented after January 2009 included the addition of preoperative 0.3% topical tobramycin, 10% povidone-iodine for cleansing, and using a disposable sterile drape. The incidence, microbiological profile, and outcomes of these cases were analyzed.
Results:
The incidence of preprotocol endophthalmitis was significantly higher than in the postprotocol period (P = 0.018). More patients in the preprotocol group grew Pseudomonas aeruginosa and Streptococcus pneumoniae as compared with those in the postprotocol group (P = 0.014). A smaller number of patients attained a poor visual outcome after the implementation of the revised protocol (P = 0.035).
Conclusions:
In our study, the addition of antibiotic eye drops before cataract surgery and perioperative cleansing with 10% povidone-iodine were effective means to reduce the incidence of postoperative endophthalmitis.
