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ABSTRACT.Purpose: To investigate the epidemiology of postoperative endophthalmitis (POE) following cataract surgery in Sweden during a 3-year period, using the framework of the Swedish National Cataract Register. Methods: Clinically presumed cases of POE were reported in a prospective survey involving all Swedish ophthalmic surgical units except one. Data on results of the intraocular culture and visual outcome after infection, as well as patient age and gender and various elements of the surgical procedure, were collected. Results: The nationwide incidence of POE was 0.0595%, representing 112 cases in 188 151 cataract operations. Gram-positive bacteria were the predominant aetiology, with an 84.6% share of culture-positive cases. A significantly decreased risk for POE was found for patients who had received prophylactic intracameral antibiotics (mainly cefuroxime) in comparison with those who had been treated with topical antibiotics only. Conclusions: The prevalence of POE after cataract surgery in Sweden is at the lower end of the spectrum of incidence currently reported in the developed world. The administration of intracameral antibiotics may have contributed to these results.

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ABSTRACT.Purpose: To investigate the morbidity of postoperative endophthalmitis (POE) following cataract surgery in Sweden in 1998. Methods: Clinically presumed cases of POE were reported in a prospective survey in which all Swedish ophthalmic surgical units except one had agreed to participate. Data on intraocular cultures and visual outcomes at 3 months after infection were supplied. Surgical cases that became infected were identified in the Swedish National Cataract Register, thereby enabling screening for various putative risk factors. Results: The nationwide incidence of POE amounted to 58 cases out of 54 666 cataract operations, or 0.1% of surgical cases. The predominant aetiology was gram-positive bacteria, which comprised 57% of the material. Acrylic intraocular lenses were found to decrease the risk of POE significantly in comparison to hydrogel and polymethylmethacrylate lenses. Conclusions: The incidence of POE after cataract surgery in Sweden is similar to that currently reported elsewhere in the developed world. We hope that continued registration of cases of POE in Sweden will shed light on the possible influences of various prophylactic measures and different intraocular lens materials on the development of postoperative infection.

Elderly patients on average had a good outcome, although not as good as that in younger patients. Certain groups were identified as having an excellent result and others of having a high risk of an adverse outcome.