Abstract
Postoperative endophthalmitis is a serious complication that can happen after cataract surgery. It occurs mainly due to invasion of the globe by microbial flora, bacteria, or fungi from the adnexa and environment during the time of surgery. All patients undergoing cataract surgery should be evaluated for any potential risk factors that can enhance the development of postoperative endophthalmitis; managing the intraoperative risk and prophylaxis protocols should be considered in order to reduce the risk of endophthalmitis. Early follow-up after cataract surgery is highly recommended to detect any sign of endophthalmitis so as to treat it immediately and ensure patient compliance on post-surgery medication and precautions to reduce the serious complications caused by late diagnosis and treatment of post-cataract endophthalmitis.
Highlights
Background the high safety of cataract surgery and the promising visual outcome, postsurgical complications do arise even with the best hand
One of the most feared complications after cataract surgery is the increased vulnerability to postoperative endophthalmitis. This mostly starts during cataract surgery where a corneal incision is made in the anterior chamber of the eye to remove the cataractous lens, which permits the entry of ocular surface fluid containing bacterial flora
The unfavorable visual outcomes of postoperative endophthalmitis in cataract surgery ranges from decreased visual acuity less than 20/200 to the loss of the eye
Summary
The high safety of cataract surgery and the promising visual outcome, postsurgical complications do arise even with the best hand. It was proved that a three-day course of antibiotics is more effective than a one-day or onehour course, especially with the synergistic effects of povidone-iodine [18] This recommendation coincides with those of retrospective studies from Spain that confirmed the significant effect of systematic intracameral cefuroxime injections in post-cataract endophthalmitis prophylaxis with growing and compelling evidence of its success relative to its price [15]. Systemic ciprofloxacin versus moxifloxacin had reported a faster resolution of hypopyon and a decreased need for repeat intravitreal antibiotics in patients with acute postoperative endophthalmitis because these drugs cross the blood ocular barrier [38]. Intravitreal antibiotics injection, IOL extraction, and vitrectomy remain the best treatment options [41]
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