All India Ophthalmological Society (AIOS) Task Force guidelines to prevent intraocular infections and cluster outbreaks after cataract surgery

Abstract

Infectious endophthalmitis is a serious and vision-threatening complication of commonly performed intraocular surgeries such as cataract surgery. The occurrence of endophthalmitis can result in severe damage to the uveal and other ocular tissues even among patients undergoing an uncomplicated surgical procedure. If the infections result from common factors such as surgical supplies, operative or operation theater-related risks, there can be a cluster outbreak of toxic anterior segment syndrome (TASS) or infectious endophthalmitis, leading to several patients having an undesirable outcome. Since prevention of intraocular infections is of paramount importance to ophthalmic surgeons, the All India Ophthalmological Society (AIOS) has taken the lead in the formation of a National Task Force to help ophthalmic surgeons apply certain universal precautions in their clinical practice. The Task Force has prepared a handy checklist and evidence-based guidelines to minimize the risk of infectious endophthalmitis following cataract surgery.

Impact of comprehensive eye examination in identifying the ocular co-morbidities in patients screened for cataract surgery through the out-reach activities

“…The All India Ophthalmic Society task force on endophthalmitis recommends thorough pre-operative evaluation of adnexa to identify risk factors for endophthalmitis. [ 4 ] We identified 98 patients with oculoplasty diseases such as nasolacrimal duct obstruction (NLDO), stye, chalazion, and etropion, which needed surgical correction (73 patients) or medical management prior to considering them for cataract surgery. We identified 54 patients with pterygium and operated 29 of them (those with astigmatism >2 D) before cataract surgery.…”

Commentary

“…Recently, the All India Ophthalmology Society (AIOS) also prepared guidelines to prevent post-surgical endophthalmitis. [ 7 ] A multi-disciplinary approach by ophthalmologists, nursing staff, schedulers, sanitary workers, microbiologists, and other clinician-scientists from the hospital/institute is necessary to achieve these goals.…”

Response to comments on: All India Ophthalmological Society (AIOS) task force guidelines to prevent intraocular infections

“…We would like to thank the authors[ 1 ] for showing interest in our manuscript by the All India Ophthalmology Society (AIOS) task force featuring guidelines for prevention of intraocular infections after surgical interventions. [ 2 ] The authors mainly address two issues which rightly need further discussion and introspection, which are (1) the issue of limiting the number of patients undergoing cataract surgery in one operating room per surgeon, maximizing the use of disposables, and optional use of intracameral antibiotics based on surgeon discretion and (2) patient features including control of blood glucose levels/diabetes. [ 1 2 ]…”

“…[ 2 ] The authors mainly address two issues which rightly need further discussion and introspection, which are (1) the issue of limiting the number of patients undergoing cataract surgery in one operating room per surgeon, maximizing the use of disposables, and optional use of intracameral antibiotics based on surgeon discretion and (2) patient features including control of blood glucose levels/diabetes. [ 1 2 ]…”

“…While the guidelines by the AIOS are named as such since they provide basic knowledge for conducting surgeries while minimizing infections, we would like to reiterate and quell the authors’ concern that these are not legally binding or mandatory, since guidelines are known to evolve as science advances. [ 2 ]…”