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An 8-year retrospective study of cataract surgery and postoperative endophthalmitis: injectable intraocular lenses may reduce the incidence of postoperative endophthalmitis
  1. Kelly Weston1,
  2. Rory Nicholson1,
  3. Catey Bunce2,3,
  4. Yit Fung Yang1
  1. 1Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
  2. 2NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
  3. 3London School of Hygiene & Tropical Medicine, London, UK
  1. Correspondence to Dr Kelly Weston, Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK; weston.dr{at}


Background/aims Postoperative endophthalmitis (POE) is a rare but potentially devastating complication of modern cataract surgery. We examine whether the use of injectable intraocular lenses (IOLs) is associated with a lower rate of POE after cataract surgery compared with forceps-inserted foldable IOLs.

Methods A single-centre retrospective cohort study of 25 410 cataract operations was performed over an 8-year period when standard practice in cataract surgery changed from the use of forceps-inserted foldable IOLs to injectable IOLs. Cases of POE were identified and the rates compared between the two groups.

Results Twelve cases of POE were identified in the study period. The rate of POE was significantly lower in the injectable IOL group compared with the forceps-inserted foldable IOL group (0.008% vs 0.081%, p=0.008). This difference remained significant when controlling for posterior capsular rupture and lens material.

Conclusions This study, the largest of its kind to date, supports the use of injectable IOLs over forceps-inserted foldable IOLs as a significant measure in reducing the risk of POE.

  • Infection
  • Prosthesis
  • Treatment Surgery
  • Microbiology
  • Lens and zonules

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