Abstract
Abstract: :
Purpose:Determination of post-operative endophthalmitis rate after cataract surgery and assessment of effectiveness of all steps in prophylaxis. Methods: Retrospective review of hospital OR logs, patient records, quality assurance minutes, billing records and infectious control records as well as collective memory were reviewed to determine the number of cataract surgical procedures done, the incidence of post-operative endophthalmitis and the methods of prophylaxis at five medical school affiliated hospitals. Results: At the five medical school/residency training program/faculty practice hospitals 11,928 cataract procedures were performed between July 1995 and July 2002 . Ninety percent of the procedures were phaco and ten percent manual ECCE. Only one case of post-operative endophthalmitis occurred for a rate of 0.84 per 10,000. The only consistent prophylaxis throughout the time period was pre-operative Cipro drops Q15 minutes x 4 pre-op, and povidone iodine lid and ocular surface prep. Intra and post-operative prophylactic approaches varied significantly by surgeon and institution. Conclusions: At our institution the extremely low endophthalmitis rate of 0.84 per 10,000 is potentially attributable to multiple factors. However, the consistent use of Cipro drops Q 15 minutes x 4 pre-op as well as lid and ocular surface preparation with povidone iodine probably contributed significantly to the extremely low rate of post-operative endophthalmitis. This study demonstrates that endophthalmitis after cataract surgery can be a rare occurrence.
Keywords: endophthalmitis • clinical (human) or epidemiologic studies: out • antibiotics/antifungals/antiparasitics