title: Six-year incidence of endophthalmitis after cataract surgery: Swedish national study.
abstract: OBJECTIVE
  To report the nationwide incidence and risk factors for endophthalmitis after cataract surgery in Sweden.
  
  
  METHODS
  Swedish National Cataract Register containing reports on cataract operations from all Swedish ophthalmic surgical units.
  
  
  METHODS
  Prospective epidemiologic study.
  
  
  METHODS
  Endophthalmitis case reports were collected from 2005 through 2010. Case and control parameters pertaining to patient characteristics and surgical technique were generated from the database. In addition, information from annual surveys regarding the topical prophylactic protocol was analyzed.
  
  
  RESULTS
  The reports showed 135 endophthalmitis cases in 464,996 operations, equaling an incidence of 0.029%. Patient age over 85 years, perioperative communication with the vitreous and, above all, nonuse of intracameral cefuroxime showed a statistically significant association with endophthalmitis in the logistic regression. Short-term topical antibiotics given as add-on prophylaxis to the intracameral regimen before, after, or before and after the operation did not confer a clear-cut benefit. Groups with topical treatment were small, comprising 14% of the sample.
  
  
  CONCLUSIONS
  The incidence of endophthalmitis after cataract surgery in Sweden is declining, which appears to be explained by a fall in the frequency of major risk factors. Operating earlier in the cataract course, avoiding capsule breakage, and giving intracameral antibiotics universally should further reduce the endophthalmitis rate.
authors.affiliation: From St. Erik Eye Hospital (Friling, Montan), Stockholm, the Department of Clinical Sciences, Ophthalmology (Lundström), Faculty of Medicine, Lund University, Lund, and Sahlgrenska University Hospital (Stenevi), Molndal, Sweden.
authors.forename: Emma
authors.initials: E
authors.lastname: Friling
authors.affiliation: From St. Erik Eye Hospital (Friling, Montan), Stockholm, the Department of Clinical Sciences, Ophthalmology (Lundström), Faculty of Medicine, Lund University, Lund, and Sahlgrenska University Hospital (Stenevi), Molndal, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Lundström
authors.affiliation: From St. Erik Eye Hospital (Friling, Montan), Stockholm, the Department of Clinical Sciences, Ophthalmology (Lundström), Faculty of Medicine, Lund University, Lund, and Sahlgrenska University Hospital (Stenevi), Molndal, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Stenevi
authors.affiliation: From St. Erik Eye Hospital (Friling, Montan), Stockholm, the Department of Clinical Sciences, Ophthalmology (Lundström), Faculty of Medicine, Lund University, Lund, and Sahlgrenska University Hospital (Stenevi), Molndal, Sweden. Electronic address: per.montan@sankterik.se.
authors.forename: Per
authors.initials: P
authors.lastname: Montan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D001419:Bacteria / Q000302:isolation & purification; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D002648:Child; D004363:Drug Utilization / Q000706:statistics & numerical data; D009877:Endophthalmitis / Q000453:epidemiology*; D015818:Eye Infections, Bacterial / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents