title: Incidence of postoperative endophthalmitis in a high-volume cataract surgicentre in Canada.
abstract: OBJECTIVE
  To determine the incidence of endophthalmitis at a high-volume, multisurgeon Canadian surgicentre and compare the endophthalmitis incidence, incision techniques, and prophylactic regimens with other published data in the worldwide literature.
  
  
  METHODS
  Retrospective, consecutive case series.
  
  
  METHODS
  Patients (13 931 eyes) who underwent cataract surgery at the Kensington Eye Institute, Toronto, Ont., from January 9, 2006, to January 6, 2008.
  
  
  METHODS
  Cases of endophthalmitis were identified from surgeon quality assurance reports. Prophylactic regimens, incision techniques, organisms cultured, and visual outcomes were reviewed in each case. All surgeons were surveyed regarding their incision techniques and prophylactic regimens.
  
  
  RESULTS
  Endophthalmitis developed in 6 eyes (incidence 0.043%). No causative organism predominated, and only 1 patient had severe vision loss to less than counting fingers. More cases of endophthalmitis (4 of 6) occurred in patients not receiving fourth-generation fluoroquinolones, despite approximately 75% of surgeons using these drugs before and after surgery (odds ratio 6.3, relative risk 6.3). No intracameral antibiotics were used in any cases, and all incisions were clear corneal.
  
  
  CONCLUSIONS
  Our incidence of postoperative endopthalmitis after cataract surgery was 0.043%. Slight evidence of reduced endophthalmitis with the use of fourth-generation fluoroquinolones was noted. Our endophthalmitis incidence compares favourably with other published rates in the medical literature, and this rate was achieved without intracameral antibiotic use in a centre that uses exclusively topical anesthesia and clear corneal incisions.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Toronto, Ont., Canada. john.lloyd@sunnybrook.ca
authors.forename: John C
authors.initials: JC
authors.lastname: Lloyd
authors.forename: Rosa
authors.initials: R
authors.lastname: Braga-Mele
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D013531:Surgicenters / Q000706:statistics & numerical data*