Intracameral Antibiotics and Cataract Surgery: Endophthalmitis Rates, Costs, and Stewardship.

Acute-onset postoperative endophthalmitis is a rare but vision-threatening complication of cataract surgery. The incidence rate varies substantially in the literature but is generally reported in the range of 0.03% to 0.2%. In the current issue of Ophthalmology, Creuzot-Garcher et al report a retrospective series of 6 371 242 phacoemulsification surgeries in which the rate of endophthalmitis declined from 0.145% to 0.053% over a 10-year period (see page XXX). During this timeframe, the use of intracameral antibiotics increased from 0.60% to 80.03%, and the investigators concluded that the intracameral antibiotics were responsible for these outcomes. These results are intriguing and illustrate the power of “Big