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Change in post-cataract surgery endophthalmitis incidence following new preventative measures

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Session Details

Session Title: Presented Poster Session: FLACS & Others

Venue: Poster Village: Pod 1

First Author: : V.Ramjiani UK

Co Author(s): :    D. Gosling   E. Bryan   R. Sheard        

Abstract Details

Purpose:

To demonstrate the change in endophthalmitis occurrence when one or more peri-operative preventative protocols were implemented in the context of cataract surgery

Setting:

Sheffield Teaching Hospitals NHS Foundation Trust, UK

Methods:

The cumulative incidence of endophthalmitis was prospectively monitored from November 2006 to September 2015. General endophthalmitis preventative measures were implemented after suspected outbreaks where no common cause could be identified. The cumulative incidence is then compared during periods of different preventative measures.

Results:

36,143 consecutive cataracts were performed with 26 endophthalmitis cases between November 2006 and September 2015. From November 2006 prophylaxis included 5% povidone iodine into the conjunctival sac and 10% povidone iodine to periocular skin pre-operatively, and 1mg of intracameral cefuroxime. Endophthalmitis incidence was 1:672. Following the introduction of a one week course of postoperative levofloxacin drops in September 2008, the incidence dropped to 1:738. Following three additional preventative measures in September 2010; switching from foldable silicone to injectable acrylic IOL, pre-operative levofloxacin, and suturing of phako wounds by all surgeons in the unit, the incidence reduced to 1:6626.

Conclusions:

Post-operative levofloxacin drops contributed a small change in endophthalmitis incidence. Switching from foldable silicone to injectable acrylic IOL, pre-operative levofloxacin, and suturing of all phako wounds, collectively led to a large reduction in endophthalmitis incidence. The relative contribution of individual interventions remains unknown.

Financial Disclosure:

NONE

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