National survey highlights risk factors for endophthalmitis after cataract surgery

Findings from the Swedish National Cataract Register tracking the incidence of endophthalmitis after cataract surgery in Sweden showed a low incidence of this complication with only 108 endophthalmitis cases after 225,000 procedures performed during 2002 and 2004, according to Mats Lundstrom, MD.

"We have been looking at some of the critical parts of cataract surgery related to endophthalmitis: incision construction, prophylactic antibiotics, and complications," said Dr. Lundstrom, of the EyeNet Sweden, Karlskrona, Sweden. He spoke during the American Society of Cataract and Refractive Surgery annual meeting.

During the study period, two-thirds of surgeons performed clear corneal incisions and one-third sclerocorneal incisions. Half of the surgeons utilized the temporal incision site and half the superior site. Almost all were using intracameral antibiotics at the end of surgery, he said.

The study showed a higher incidence of endophthalmitis utilizing the clear corneal incision versus the sclerocorneal incision. The temporal incision also posed a greater risk for endophthalmitis than the superior incision site. However, neither comparison reached statistical significance, he said.

"Temporal or clear corneal incisions increase the risk of postoperative endophthalmitis moderately and generate one additional case per 6,000 procedures," Dr. Lundstrom noted.

There was also an increased risk of endophthalmitis in cases involving vitreous complications, he said.

"Systematic quality control improves routines and outcomes," Dr. Lundstrom concluded. "We found that intracameral antibiotics can significantly reduce the incidence of endophthalmitis at least in the average Swedish setting."