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2004 OMIG, Abstract 16

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A Study of the Effectiveness of Preoperative Antibiotics on the Incidence of Postoperative Endophthalmitis in a Clinical Setting
GM Bohigian. Department of Ophthalmology, Washington University, St Louis, Missouri

Purpose: 1) To determine the incidence of culture positive endophthalmitis after cataract surgery in an ambulatory care center and 2) analyze the effects of preoperative antibiotics in preventing endophthalmitis.
Methods: A retrospective series of 30,870 cataract surgery cases over a 14-year period at an ambulatory care center was reviewed. Cases with and without the use of preoperative pledgets (Merocel) soaked with topical ciprofloxacin were studied.
Results: The initial 19,529 cases from 1990 to 1998 (9 years) were performed without the use of third generation ciprofloxacin. The following 11,341 cases from 1999 to 2003 (5 years) were performed using topical preoperative ciprofloxacin. Both groups had the usual and customary preparation including 5% povidone iodine. There were five cases of culture positive endophthalmitis in each group. The incidence of culture proven endophthalmitis was 0.03% (1 in 3000) and 0.04% (1 in 2268) respectively (no statistically significant difference).
Conclusions: The incidence of culture proven endophthalmitis was low. The use of topical antibiotics (third generation fluoroquinolones) in this series did not appear to lower the incidence of culture proven endophthalmitis after cataract surgery. The types of organism, multiple variables, possible pathogenesis, and the future direction of surgical prophylactic using fourth generation fluoroqrinolones will be discussed.

Disclosure code: N

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