Endophthalmitis After Cataract Surgery: An Update on Recent Advances

Travis J. Peck; Samir N. Patel; Allen C. Ho


Curr Opin Ophthalmol. 2021;32(1):62-68. 

In This Article

Immediately Sequential Bilateral Cataract Surgery and Risk of Endophthalmitis

Immediately sequential bilateral cataract surgery (ISBCS) refers to the practice of performing cataract surgery on both eyes on the same day rather than delaying surgery on the second eye for days to weeks. This has been adapted by many surgeons as a means to improve productivity, patient satisfaction, and costs.[23] An ASCRS survey in 2015 found that 20% of surgeons were performing ISCBCS in the United States,[24] but this number is much higher in countries such as Finland and Sweden and is increasing throughout the world.[23] One of the largest downsides to adopting this practice is the potential for bilateral endophthalmitis, leading to devastating vision loss. There are six reported cases of bilateral endophthalmitis after ISBCS in the literature, and in five of these cases, the surgical protocol recommendations set forth by the International Society of Bilateral Cataract Surgeons was breached (Table 1).[25,26] Information regarding equipment and surgical details for the sixth case was not available.[25] It has been shown that rates of unilateral endophthalmitis in ISBCS are comparable to those seen in unilateral cataract surgery.[27] Thus, it appears that if meticulous attention is paid to surgical protocol as outlined by the ISBSC guidelines, risk of endophthalmitis should not inhibit wide-spread adaptation of ISBCS.