The incidence following cataract surgery is likely around 1 in 1,000 (1,58). Although there is no conclusive evidence tas 71 live supporting the use of topical antibiotic prophylaxis, these agents are very widely used. Many studies report a significant reduction of conjunctival flora with the use of topical antibiotics, but it is uncertain if this reduction actually decreases endophthalmitis rates (34).

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Minute amounts of foreign substances may incite inflammation, and the large number and variety of surgical instruments used, as well as their different sterilization processes, make prevention challenging. Proper cleaning of surgical instruments and sterilization remain important for reducing rates of TASS (102). When povidone-iodine cannot be used for cataract surgery (although true allergy is rare), the use of topical chlorhexidine gluconate may be considered, although this agent may be toxic to the cornea (20,32).