Cataract surgery and incidence of postoperative endophthalmitis in Israel

Background: Cataract surgery is the most common surgery in ophthalmology. Acute postoperative endophthalmitis is one of the most serious complications of cataract surgery and may result in severe visual impairment and even loss of the eye. In Israel there is no established and controlled registry on the number of operations or the rate of postoperative complications. Aim: To survey the total number of cataract operations performed annually in Israel, to investigate trends in surgical techniques and intraocular lenses used, and to study the rate of postoperative acute endophthalmitis. Methods: Since the year 1990, a questionnaire regarding cataract surgery has been sent to all of the recognized inpatient and ambulatory surgical centers in the country. As of the year 2000, a questionnaire regarding postoperative endophthalmitis was added. Results: The number of cataract operations performed annually demonstrates a constant increase in the last decade. In the last survey, conducted in 2004, there was a total estimated number of 39,000 operations. The incidence of post cataract endophthalmitis ranged between 0.13%-0.25%, with a downwards tendency in the past years. Conclusions: The constant increase in the number of cataract operations probably reflects both a true increase in the rate of operations, as well as better retrieval of data. The number of surgeries relative to the size of the population of Israel is within the lower limits of the range accepted in the industrialized world. The incidence of acute postoperative endophthalmitis is similar to that reported in controlled series. There is a need for an established controlled registry including information on the number of operations and the rate of complications.