A study of the incidence of culture-positive endophthalmitis after cataract surgery in an ambulatory care center.
OBJECTIVE
To determine the incidence of culture-positive endophthalmitis after cataract surgery in an ambulatory surgical care center and to analyze the effectiveness of povidoneiodine solution in the preoperative preparation in preventing culture-positive endophthalmitis.


METHODS
A retrospective series of 19,269 consecutive cases of cataract extraction with lens implantation over 12 years in an ambulatory care center was reviewed.


RESULTS
Nine cases of culture-positive endophthalmitis occurred, for an incidence of 0.05%. The initial 4,740 cases (1985-1989) were performed without the use of povidone-iodine; the following 14,529 cases (1990-1996) were done using povidone-iodine. The incidence of culture-positive endophthalmitis was 0.08% and 0.03%, respectively.


CONCLUSIONS
The incidence of culture-positive endophthalmitis in this series was very low. The use of 5% povidone-iodine, topically, appeared to be beneficial in reducing the incidence of culture-positive endophthalmitis after cataract extraction (P=0.24), but was not statistically significant in this retrospective series. Evaluation and methods to prevent endophthalmitis are difficult in retrospective clinical studies due to multiple variables and the rarity of this complication.
Bohigian
G M
GM
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA.
D000554:Ambulatory Care Facilities; D000556:Ambulatory Surgical Procedures; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001419:Bacteria / Q000254:growth & development / Q000302:isolation & purification; D002387:Cataract Extraction / Q000009:adverse effects*; D015169:Colony Count, Microbial; D009877:Endophthalmitis / Q000382:microbiology* / Q000517:prevention & control; D015818:Eye Infections, Bacterial / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D019654:Lens Implantation, Intraocular; D011206:Povidone-Iodine / Q000627:therapeutic use; D012189:Retrospective Studies
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine