Prophylaxis and therapy of acute postoperative endophthalmitis after cataract extraction – state of the art

Background: Cataract extraction is one of the most frequently performed surgical procedures in medicine. Incidence could be lowered over the last decades due to advances in operation techniques and perioperative regimes. However, acute postoperative endophthalmitis still remains a vision threatening disease. The up to now best – evidence based – perioperative regime to prevent the disease and recommended therapy will be discussed. Results: The incidence of acute postoperative endophthalmitis can be significantly decreased by the instillation of 0.1 ml cefuroxime (1 mg/0.1 ml) into the anterior chamber at the end of the cataract operation. Acute postoperative endophthalmitis should be treated immediately by performing an intravitreal injection of vancomycin (1 mg/0.1 ml) as well as ceftazidime (2 mg/0.1 ml) and – if possible – vitrectomy. Conclusions: An efficient perioperative regimen offers the possibility to decrease the incidence of acute postoperative endophthalmitis significantly. If necessary, treatment should be initiated immediately, so an improvement of visual acuity can be accomplished in many cases. © 2016, The Author(s).