A retrospective study of the incidence of culture-positive endophthalmitis after cataract surgery and the use of preoperative antibiotics

BACKGROUND AND OBJECTIVE: To determine the incidence of culture-positive endophthalmitis after cataract surgery in an ambulatory surgery center and to analyze the effect of a specific preoperative antibiotic regimen in reducing the incidence of endophthalmitis. PATIENTS AND METHODS: The medical records of 30,870 consecutive eyes undergoing cataract extraction at a single ambulatory surgery center were reviewed retrospectively. Complications of the cataract surgeries, including endophthalmitis, were collected. RESULTS: Cataract surgery was performed without the use of preoperative topical antibiotics on 19,529 eyes from 1990 to 1998 (Group 1) and using topical preoperative ciprofloxacm-soaked pledgets on 11,341 eyes from 1999 to 2003 (Group 2). Five eyes had culture-positive endophthalmitis in each group. The incidence of culture-positive endophthalmitis was 0.03% (1 in 3,000) in Group 1 and 0.04% (1 in 2,268) in Group 2 (P = 1.0). CONCLUSIONS: The incidence of postoperative endophthalmitis in this study was low. A preoperative pledges soaked with a second-generation fluoroquinolone did not appear to lower the incidence of culture-positive endophthalmitis after cataract surgery in this series.