An 8-year retrospective study of cataract surgery and postoperative endophthalmitis: injectable intraocular lenses may reduce the incidence of postoperative endophthalmitis

BACKGROUND/AIMS: Postoperative endophthalmitis (POE) is a rare but potentially devastating complication of modern cataract surgery. We examine whether the use of injectable intraocular lenses (IOLs) is associated with a lower rate of POE after cataract surgery compared with forceps-inserted foldable IOLs. METHODS: A single-centre retrospective cohort study of 25 410 cataract operations was performed over an 8-year period when standard practice in cataract surgery changed from the use of forceps-inserted foldable IOLs to injectable IOLs. Cases of POE were identified and the rates compared between the two groups. RESULTS: Twelve cases of POE were identified in the study period. The rate of POE was significantly lower in the injectable IOL group compared with the forceps-inserted foldable IOL group (0.008% vs 0.081%, p=0.008). This difference remained significant when controlling for posterior capsular rupture and lens material. CONCLUSIONS: This study, the largest of its kind to date, supports the use of injectable IOLs over forceps-inserted foldable IOLs as a significant measure in reducing the risk of POE.