Intracameral vancomycin following cataract surgery: An eleven-year study

AIM To compare the incidences of endophthalmitis after cataract operations before and after introduction of intracameral vancomycin at the end of surgery. METHODS A retrospective analysis was performed of presumed infectious endophthalmitis after cataract surgery from January 1, 1998 to December 31, 2008. From January 2001, the practice of using intracameral vancomycin at the end of cataract surgery was introduced. The period before introduction of intracameral vancomycin is considered as period A and that after as period B. The incidences of presumed or culture-proven endophthalmitis during periods A and B were compared. RESULTS A total of 16,606 cataract surgeries were performed during the study period. The incidence of endophthalmitis per 1000 cataract surgeries was 3.0 during period A and 0.08 during period B. This reduction was statistically significantly (Chi-squared test 36.6, P value < 0.0001). The relative risk of developing endophthalmitis without intracameral vancomycin prophylaxis was 38. The absolute risk reduction was 292 cases of endophthalmitis per 100,000 cataract surgeries. CONCLUSIONS Intracameral vancomycin significantly reduced the incidence of postoperative endophthalmitis after cataract surgery. There is a universal need to adopt this mode of microbial prophylaxis to reduce the burden of endophthalmitis after cataract surgery.