Endophthalmitis following cataract extraction. A study of 24 cases in 4,498 operations

The incidence of postoperative endophthalmitis in a series of 4,498 consecutive cataract operations, performed in a period of 10 years, was examined and found to equal 0.533%. Paracentesis of the anterior chamber was done in two cases and revealed Staphylococcus albus to be the causative organism in both instances. Conjunctival cultures were recovered in a further 17 cases, and showed S. albus in pure culture in eight cases and in combination with Pseudomonas aeruginosa and Proteous morgani in two cases. Streptococcus haemolyticus was isolated in pure culture in one case, while the cultures from six other patients were negative. The role of such factors as age, diabetes mellitus, chronic bronchitis, "weak ocular tissue", and persurgical complications which predisposed to postoperative infections was examined and found to have no significance on the occurrence of endophthalmitis in the present study. The visual end results were assessed and showed a better prognosis than generally expected. Of 24 cases, five achieved good visual acuity (6/6-6/12), 13 had a useful vision (6/18-6/60), while five remained actually blind (less than 6/60). In only one case was the eye enucleated. Methods of treatment and prophylaxis are described and discussed. A total suppression or elimination of all regional bacteria at the time of surgery seems to be the logical goal.