M A R C H 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 0 7
nificantly associated with the infections.
To be clear, intracameral injections are not the "dropless"
approach that's recently been touted. "The 'dropless' is injected
into the vitreous," says Dr. Newsom. "This is all just into the ante-
rior chamber. It's just a little squirt at the end of the case."
Another study found a significant correlation between posterior
capsular ruptures that occur during anterior vitrectomies and the
development of endophthalmitis. That makes sense, says Dr.
Newsom. "When you hit the interior vitreous, you go from a 5-
minute cataract surgery to a 15- to 20-minute cataract surgery.
You have to clean it up, so you're in the eye longer. There's just a
higher risk of all kinds of complications, and endophthalmitis is
one of those complications."
Specifically, according to data culled from the Royal College of
Opthalmologists' National Ophthalmology Database,
(osmag.net/3yrzca), which looked at more than 180,000 eyes from
nearly 128,000 patients, "the rate of endophthalmitis within 3 months
of cataract surgery was approximately 8 times higher in cases with
posterior capsular rupture than [it was in] those without."
Ruptures happen to every ophthalmologist, says Dr. Newsom.
"If you do enough surgeries, you're going to have a broken cap-
sule. There's no way around it. But when it happens, you need to
think about that much higher risk and always give intracameral
antibiotics."
In Dr. Newsom's case, when ruptures happen, he'll be doing
everything he can to keep an impressive streak of success alive.
"Luckily, I'm 40,000 surgeries in and have had zero cases of
endophthalmitis," he says.
— Jim Burger
