Endophthalmitis rates and risk factors following intraocular surgeries: can we turn big-data benchmarks into patient benefit?

Endophthalmitis, although a frequently blinding complication of intraocular surgery when it does occur, is increasingly rare in the modern era of ophthalmic surgery. Other than for cataract surgery, which has sufficiently large volume to permit estimates of rates for even the rarer complications, endophthalmitis rates in other intraocular surgical procedures are difficult for surgeons or institutions to evaluate in their own practice, and to know if they are performing to an adequate standard in attempts to protect patients. Similarly, it is difficult to provide accurate estimates of risk during the process of informed consent. By publishing the endophthalmitis rates from the US Medicare population 2016-2019, the authors have given us the opportunity to take the infection rates from less frequently performed intraocular operations from their very large dataset and either utilise these for audit and informed consent, or to adapt them based on their relative frequencies compared to cataract postoperative infection rates. This data, therefore, may open the door to greater opportunities for eye surgery providers to reflect on their performance in infection prevention following intraocular surgery.