Prevention of endophthalmitis with cataract surgery <i>: where are we now 20 years after the ESCRS Study?</i>

species are the most commonly recovered organisms, followed by other Gram-positive organisms and, less frequently, Gram-negative organisms. Strategies to prevent infection aim to limit organisms entering the eye by reducing organisms on the ocular surface, preventing intraoperative intraocular bacterial contamination and preventing postoperative bacterial contamination with watertight wound closure. Secondary strategies target the eradication of organisms that (despite all precautions) might have entered the eye, including intracameral antibiotic administration. Topical ophthalmic antisepsis with administration of povidone-iodine reduces the clinical occurrence of endophthalmitis with cataract procedures. Evidence demonstrates similar low rates of postoperative endophthalmitis after cataract surgery using standardised preoperative preparation alone, with or without intracameral antibiotic administration, in routine, uncomplicated cases. Stratification of risk guides possible adjunctive intracameral antibiotic administration in addition to standardised prevention practices, with individuals at higher risk, including those undergoing same-day bilateral surgery or with complicated and combined procedures.