Wound infection after cataract surgery.

Nineteen patients were treated for bacterial and fungal infection of the sclerocorneal incision following cataract extraction during a 19-year period. The infections were caused by Staphylococcus aureus (2), Staphylococcus epidermis (2), Streptococcus pneumoniae (3), Streptococcus viridans (1), Pseudomonas aeruginosa (1), Mycobacterium fortuitum (3), Aspergillus flavus (6), and Candida tropicalis (1). The predisposing factors involved were an obstructed nasolacrimal duct (S. pneumoniae, S. viridans), airborne contamination of the wound by fungal spores (A. flavus), and defective sterilization of instruments (M. fortuitum). Ten of the 19 infections resulted in complete loss of the eye from endophthalmitis. Early recognition of wound infection by frequent meticulous examination of the sclerocorneal incision for infectious infiltration is of utmost importance so that specific therapy can be instituted immediately to prevent the development of endophthalmitis.