Endophthalmitis following cataract surgery: the role of prophylactic postoperative chloramphenicol eye drops

Abstract

Purpose: The main aim of the study was to assess whether omitting prophylactic postoperative topical antibiotics (chloramphenicol) influenced the risk of developing endophthalmitis after cataract surgery.

Methods: We conducted a retrospective study including all patients who had cataract surgery at our outpatient cataract unit between 2004 and 2011. Postoperative topical antibiotics (chloramphenicol) were omitted from 2007 onwards, as was the first postoperative day review. Patients with a diagnosis of endophthalmitis after cataract surgery were extracted, and the rate of postoperative endophthalmitis (PE) before and after changing these routines was compared. The diagnosis of PE was defined as severe intraocular inflammation requiring prompt vitreous sampling for culture.

Results: Seven thousand one hundred and twenty-three and 8131 cataract surgeries were performed in the following periods: January 2004 through December 2006 (period 1) and January 2007 through December 2010 (period 2), respectively. Five cases of PE were identified in period 1 (0.070%) and four patients in period 2 (0.049%). The median time between cataract surgery and onset of symptoms was 6 days in period 1 and 4.5 days in period 2. Median time for intervention was 7 and 5 days postsurgery, respectively.

Conclusion: We found no difference in the frequency of PE following cataract surgery when changing the postoperative topical medication from a mixture of corticosteroids and antibiotics to only corticosteroids.