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The incidence of postoperative endophthalmitis before and after a revised preoperative surgical site preparation protocol

Poster Details

First Author: V.Jhanji HONG KONG

Co Author(s):    P. Kwok   W. Yip   C. Chan   A. Young     

Abstract Details



Purpose:

To compare the incidence of postoperative endophthalmitis before and after the implementation of pre-operative surgical site preparation protocol for cataract surgery

Setting:

Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital in Hong Kong

Methods:

The incidence, epidemiology and microbiological findings of patients who suffered from acute post-operative endophthalmitis after cataract extraction over 7 years (from 1st January 2006 to 31st August 2013) were reviewed. A revised protocol of pre-operative surgical site preparation was implemented after 1st January 2009. The revised components of the protocol included the addition of pre-operative topical tobramycin, using 10% instead of 5% povidone Iodine for cleansing the peri-ocular skin and using a disposable sterile drape.

Results:

The overall incidence of post-operative endophthalmitis was 0.11%. Over the first three years with the old protocol (pre-protocol period) the endophthalmitis rate was 0.18% (18/10237). After the implementation of the revised pre-operative protocol (post-protocol period), the incidence reduced to 0.08% (13/17004) (p=0.018). There was a significant reduction in the proportion of patients who attained a poor visual outcome after the implementation of revised protocol (p=0.035). More patients in the pre-protocol group grew Pseudomonas aeruginosa and Streptococcus pneumoniae as compared to the post-protocol group patients (p= 0.014).

Conclusions:

In our study, the addition of prophylactic antibiotic eye drops before cataract surgery & perioperative cleansing with 10% povidone iodine were effective means to reduce the incidence of postoperative endophthalmitis after cataract surgery. FINANCIAL INTEREST: NONE

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