Endophthalmitis Rates Following Routine Cataract Surgery With And Without Prophylactic Post-Operative Topical Antibiotics

To evaluate endophthalmitis rates following routine cataract surgery with and without post-operative antibiotic drops in a large population.

Optegra Eye Health Care

We conducted a retrospective audit of endophthalmitis cases reported in the electronic medical records of patients undergoing phacoemulsification cataract surgery at a multicentre specialist eye hospital group. Group A (n=12,517 eyes) received standardised antisepsis protocols including povidone-iodine, intracameral cefuroxime perioperatively, postoperative topical corticosteroid drops and postoperative topical antibiotic drops. Group B (n=55,700 eyes) had surgery with the same protocols including intracameral cefuroxime, post-operative topical corticosteroid drops but no topical post-operative antibiotic prophylaxis. Patients were reviewed at 4-6 weeks post-operatively. Endophthalmitis rates were compared.

The overall rate of endophthalmitis was 0.015%.  Group A experienced 1 case of endophthalmitis (0.01%), while the rate for Group B was 0.02%. Chi-square analysis revealed no statistically significant difference between groups (p>0.05). Rates for both cohorts were low and within industry benchmark standards.

Implementation of stringent antisepsis techniques and intracameral cefuroxime used peri-operatively contributed to low endophthalmitis rates in this cohort of patients. These data further support the notion that the addition of routine postoperative antibiotics does not significantly reduce the incidence of endophthalmitis further, promoting antibiotic stewardship without compromising patient safety.