Endophthalmitis is a rare but serious postoperative complication
of cataract surgery. The incidence of endophthalmitis has been reported to be between 0.13% and 0.7%. This complication can cause irreversible blindness, so it is important to understand the risk factors and take steps to reduce the chances of developing endophthalmitis after cataract surgery. Postoperative endophthalmitis is generally due to the perioperative introduction of microbial organisms into the eye, either from the patient's normal conjunctival and epidermal flora or from contaminated instruments.
Other risk factors include intraoperative or postoperative contamination of the anterior chamber, pathogenicity of the organism, and the host's response. Endophthalmitis after cataract surgery usually follows one of two cycles: early onset or late onset. Early onset endophthalmitis occurs a few days after surgery and is often caused by Staphylococcus species. Late-onset endophthalmitis is characterized by chronic inflammation and is mainly caused by microorganisms with low virulence, such as coagulase-negative staphylococci or Propionibacterium acnes.
To reduce the risk of postoperative endophthalmitis, all patients undergoing cataract surgery should be evaluated for any possible risk factors. Intraocular antibiotics are recommended for prophylaxis in high-risk patients, such as those with a history of ocular infection or trauma, previous intraocular surgery, or immunosuppression. The use of fourth-generation fluoroquinolones has been shown to reduce the risk of postoperative endophthalmitis after cataract surgery without complications. Early monitoring after cataract surgery is strongly recommended to detect any signs of endophthalmitis and treat it immediately.
Patients should also take the necessary medication and precautions after surgery to reduce serious complications caused by late diagnosis and treatment of post-cataract endophthalmitis. Although the incidence of endophthalmitis has not changed significantly over time, it is still a serious complication that can cause irreversible blindness. It is important for patients to understand the risk factors and take steps to reduce their chances of developing endophthalmitis after cataract surgery.