Endophthalmitis and incision construction.
OBJECTIVE
The relationship between endophthalmitis after cataract extraction and type of incision has been under debate lately. In particular, clear corneal incisions have been connected with an increased incidence of postoperative endophthalmitis. This review discusses recent reports within this area.


RESULTS
Experimental studies have demonstrated the poor integrity of a clear corneal incision under certain circumstances. A relationship between wound leakage the day after surgery and endophthalmitis has also been reported. Some large studies have shown an increase of endophthalmitis that in time coincide with the increasing use of clear corneal incision. One earlier randomized controlled study showed a higher incidence of endophthalmitis after clear corneal incision compared with superior incision. Other case series have shown an equal distribution of endophthalmitis between surgeries using different types of incision. Some studies point to the multifactorial nature of endophthalmitis and the importance of every step from antiseptic surgical field to postoperative treatment.


CONCLUSIONS
There is no conclusive evidence of the relationship between clear corneal incision and endophthalmitis. It seems, however, that in certain situations clear corneal incision may play a role in the occurrence of endophthalmitis.
Lundström
Mats
M
EyeNet Sweden, Blekinge Hospital, SE-371 85 Karlskrona, Sweden. mats.lundstrom@ltblekinge.se
D002387:Cataract Extraction; D003315:Cornea / Q000601:surgery*; D009877:Endophthalmitis / Q000209:etiology*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications; D014945:Wound Healing