A few simple changes can dramatically reduce endophthalmitis

Changes to perioperative management of cataract patients, including the use of disposable bimanual irrigation/aspiration handpieces, intracameral cefuroxime and povidone iodine wash can be effective in reducing the instances of endophthalmitis, according to Richard Packer from the King Edward VII Hospital, Windsor, UK.

These changes were made following a cluster of postoperative endophthalmitis cases (nine in a four-month period). Since the introduction of the new regimes in May 2004, a total of 7,584 eyes were operated on for cataract at the hospital's Prince Charles Eye Unit. Twenty-four different surgeons, including six consultants, three associate specialists and 15 trainees carried out the surgery.

One culture-negative endophthalmitis was recorded, this recovered after intravitreal antibiotics to achieve an uncorrected vision of 6/9 by three weeks postoperatively. This represents an incidence of just 0.013% which is well below that reported in the relevant literature.

Dr Packard concluded that it only takes the implementation of a few simple measures to dramatically reduce the incidence of postoperative endophthalmitis.