Objective:

To review the evolution of prevention, diagnosis, and treatment of endophthalmitis over the past century, highlighting its significance in ophthalmic care.

Key Findings:

• Current endophthalmitis rates after cataract surgery range from 0.02% to 0.2%, with a 2022 report showing a rate of 0.068%, indicating a need for ongoing vigilance.
• Significant reductions in endophthalmitis rates have been achieved through improved surgical practices and prophylactic antibiotics, underscoring the impact of evidence-based medicine.
• The introduction of intracameral cefuroxime showed a 5-fold reduction in endophthalmitis incidence, though its adoption is not universal, highlighting disparities in practice.

Interpretation:

Despite advancements, endophthalmitis remains a risk in cataract surgery, and prevention strategies continue to evolve, with ongoing research focusing on optimizing prophylactic measures.

Limitations:

• The effectiveness of prophylactic antibiotics, particularly intracameral cefuroxime, has been debated and may not be universally applicable, raising questions about study designs.
• Variability in practices and reporting standards may affect the consistency of endophthalmitis incidence data, necessitating standardized protocols.

Conclusion:

Endophthalmitis prevention has improved significantly, but it is not entirely preventable, highlighting the need for ongoing research and adaptation of practices to enhance patient safety.