Purpose: To compare the incidence of postoperative endophthalmitis before and after the implementation of a preoperative surgical site preparation protocol for cataract surgery.
Design: Retrospective cohort study.
Methods: Records of patients with postoperative endophthalmitis between January 2006 and August 2013 were reviewed. A revised protocol implemented after January 2009 included the addition of preoperative 0.3% topical tobramycin, 10% povidone-iodine for cleansing, and using a disposable sterile drape. The incidence, microbiological profile, and outcomes of these cases were analyzed.
Results: The incidence of preprotocol endophthalmitis was significantly higher than in the postprotocol period (P = 0.018). More patients in the preprotocol group grew Pseudomonas aeruginosa and Streptococcus pneumoniae as compared with those in the postprotocol group (P = 0.014). A smaller number of patients attained a poor visual outcome after the implementation of the revised protocol (P = 0.035).
Conclusions: In our study, the addition of antibiotic eye drops before cataract surgery and perioperative cleansing with 10% povidone-iodine were effective means to reduce the incidence of postoperative endophthalmitis.
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