Rate of Infectious Postoperative Endophthalmitis Without Preoperative Topical Antibiotic Use
Purpose
This is a pilot study to determine the perioperative endophthalmitis prophylaxis regimens employed for cataract surgery in a single Louisiana state hospital and to determine the rate of postoperative infectious endophthalmitis for these surgeries.
Methods
Retrospective chart review of resident performed cataract surgeries between 2009 and 2013 at University Medical Center, a Louisiana State University Hospital.
Results
1,137 resident performed cataract surgeries were reviewed. 92.2% (1,048/1,136) of cases were successful in following up until the one-month postoperative period (days 14-31). There were no topical preoperative antibiotics used in 96.9% (1,015/1,048) of cases. There was a 9.0% (95/1,048) intraoperative complication rate. There was a statistically significant relationship between intraoperative complications and intraoperative antibiotic administration (df=2, N=1-48, X2=14.094, p=0.0002). The rate of acute postoperative infectious endophthalmitis was 0.095% (1/1,048). There was no statistically significant difference between our determined rate of infectious postoperative endophthalmitis and the rate reported by experienced ophthalmologists (1-sided Fisher's exact, p=0.400) or by other residents (1-sided Fisher's exact, p=0.690).
Conclusion
Eliminating the use of topical preoperative antibiotics does not appear to increase the rate of endophthalmitis after cataract surgery. This suggests topical preoperative antibiotic prophylaxis in cataract surgery may not be effective in reducing the rate of postoperative infectious endophthalmitis.