New ways to stop surgical infections?

Recently an article was published that was actually able to show a statistically significant reduction in infections after cataract surgery. The reason that it is very hard to show any significant changes in infection rates is that the rates are so low that you have to have a ton of patients to be able to have enough infections to find a difference in rates. This makes it hard to find new ways to reduce infections, but it is really a good thing because it means that very very few people ever get infections. The study was done in Japan. These researchers showed that they could reduce the rate of infection by doing extra cleanup at the end of surgery, specifically from around all sides of the lens implant (note: in cataract surgery, the cataract is removed and a lens implant is put in its place). With extra cleanup, 0 out of 6,147 surgery patients developed infection. Without that extra clean up, they found that 3 out of 3,570 patients got an infection. That’s 3 versus 0 and there were almost twice as many extra cleanup patients! This has not been reproduced by anyone, so you have to take it with a grain of salt, but it makes me want to be super sure that I do extra cleanup at the end of surgery.

Here is a reference for the article.

Oshika T and Ohashi Y. Endophthalmitis after cataract surgery: Effect of behind-the-lens washout. J Cataract Refract Surg. 2017 Nov;43(11):1399-1405.