Safety program linked to 64.4% lower postoperative endophthalmitis

At Fudan University in Shanghai, the incidence of postoperative endophthalmitis fell from 0.038% before a new safety program to 0.013% afterward. Biyun Zhan and colleagues reached that result by comparing 191,657 inpatients undergoing ophthalmic surgery across the 2017–2019 and 2020–2023 periods.

The intervention was deliberately spread across the surgical process. It brought together visual safety cues, periodic training and education, tighter regulation of surgical instruments, surface microbial sampling, and video-based performance review.

The overall decline was 64.4%, and the researchers reported a continuing downward annual trend, with an incidence rate ratio of 0.619. Patients undergoing cataract and crystalline lens surgery had the highest POE incidence across the study period, at 0.055%; in that subgroup, the rate fell from 0.132% before the intervention to 0.021% afterward, a greater than sixfold reduction.

So what changes in practice? For an ophthalmic surgery center, the findings describe a coordinated package spanning staff training, instrument controls, environmental sampling and performance review. The authors say the approach may be scalable to ophthalmic and general surgery centers, while the evidence here remains a before-and-after study from the Fudan center rather than a comparison across hospitals.