Retrospective Evaluation Of Causative Factors For Endophthalmitis After Cataract Surgery Performed Over 20 Years

1. Seung Jeong Lim
2. Young Ghee Lee
3. Chang Yeon Lee
4. Tae Kyun Kim

Seran Eye Center, Seoul, Korea

Purpose; To determine the incidence of endophthalmitis after cataract surgery and investigate causative factors of endopthalmitis

Methods; Retrospecitive chart review was performed. All patients had phacoemulsification by one surgeon (Seung Jeong Lim) during 1990 to 2009. According to the major surgical procedure change, all cases were separated by three consecutive periods. Incison size, type of antibiotics, pre and postoperative managements were compared.

Results; 30355 eyes had cataract surgery over 20 years. The incidence of endophthalmitis was 0.07%(7 cases of 10015) from 1991 to 2000(group I), 0.04%(4 cases of 9675) from 2001 to 2005(group II) and 0%(0 case of 10665) from 2005 to 2009(group III). In group I, 6 mm sclera pocket incision or 3 mm clear corneal incision were used and ofloxacin was used postoperatively. In group II, 3mm clear corneal incision was used and ofloxacin was used pre and postoperatively. In group III, 2.2mm clear corneal incision was used and moxifloxacin was used pre and postoperatively. 5% povidone-iodine solution was applied in conjunctival sac before surgery and open-shield was used at night for protection in group III.

Conclusions; Smaller incision size and fourth-generation fluoroquinolone may be important factor to reduce the incidence of postoperative endophthalmitis. Additionally, 5% povidone-iodine conjunctival preparation and postoperative use of night shield may affect the endophthalmitis incidence.