Post-Cataract Surgery Endophthalmitis Prophylaxis Survey in Thai Ophthalmologists

To determine current perioperative practice patterns for the prevention of endophthalmitis following cataract surgery in Thailand.

Cross-sectional Survey Study.

An online questionnaire was distributed nationwide to certified ophthalmologists, consisting of 21 questions covering 10 preoperative, 7 intraoperative, and 4 postoperative measures for the prevention of post-cataract surgery endophthalmitis. Subgroup analyses were performed to compare practices between general ophthalmologists, retina/uveitis specialists (R/U), and other subspecialists (Non-R/U).

A total of 426 responses were analyzed. Preoperative topical antibiotics (21.1%, n = 90) and oral antibiotics (4.9%, n = 21) were rarely prescribed. The most common antiseptic for skin preparation was 10% povidone-iodine (72.3%, n = 308). Intracameral antibiotics were adopted by 54.7% of respondents (n = 233). Postoperative topical antibiotics were almost universally prescribed (99.5%, n = 424). Moxifloxacin was the most preferred topical (preoperative: 45.6%, n = 41, postoperative: 46.4%, n = 197) and intracameral (57.1%, n = 133) antibiotic. Subspecialty analysis revealed that R/U specialists were more prone to use 10% povidone-iodine (relative risk ratio [RRR] 2.37, 95% CI 1.16 to 4.82) and antiseptic applied to fornix (RRR 2.62, 95% CI 1.26 to 5.46) than the general ophthalmologist group.

Although the majority of Thai ophthalmologists align their practices with international endophthalmitis prevention guidelines, certain practices were less frequently adopted than recommended. These findings emphasize the need for standardized national practice patterns to enhance surgical outcomes.