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Postoperative endophthalmitis associated with sutured versus unsutured clear corneal cataract incisions
  1. Susan S Thoms,
  2. David C Musch,
  3. H Kaz Soong
  1. Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to: Dr S S Thoms University of Michigan, Center for Specialty Care, 19900 Haggerty Road, Suite 111, Livonia, MI 48152, USA; sthoms{at}


Aim: To compare the incidence of postoperative endophthalmitis in clear corneal cataract surgeries performed with and without suture closure, antibiotics and povidone iodine.

Setting: Ambulatory surgery facility.

Methods: In a retrospective, consecutive case-series study, we reviewed the incidence of endophthalmitis in 815 consecutive eyes that underwent cataract surgery by a single surgeon over a 5-year period (379 unsutured and 436 sutured, 294 without and 521 with antibiotic drops in the immediate postoperative period, and 247 without and 568 with povidone iodine before patching).

Results: There were five cases of culture-positive postoperative endophthalmitis in the unsutured group and none in the sutured group (p = 0.022). Although patients in these two groups received routine preoperative antibiotic and povidone-iodine drops, those in whom antibiotic eye drops were not initiated until the day after surgery (p = 0.006) and those who did not receive 5% povidone-iodine drops immediately after wound closure (p = 0.031), had a higher incidence of endophthalmitis.

Conclusion: Results suggest that by suturing the corneal incisions, by initiating antibiotic eye drops within the first 24 h of surgery and by instilling povidone-iodine drops after closure, the incidence of endophthalmitis after cataract surgery could possibly be reduced.

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  • Funding: this research was supported in part by a departmental grant from Research to Prevent Blindness, Inc, New York, New York, USA. The authors have no proprietary or financial interest in any product mentioned in this study.

  • Competing interests: None.

  • This study was approved by the University of Michigan IRB.

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