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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


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


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


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.


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).


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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