Background-Anterior chamber aspirates on completion of extracapsular c
ataract surgery contain significant numbers of organisms, particularly
coagulase negative staphylococci, an important cause of endophthalmit
is. Methods-Culture rates were compared in 50 patients after phacoemul
sification surgery, which allows the possible benefits of a small, sel
f sealing wound and maintenance of positive intraocular pressure, with
a similar number of extracapsular cases. Results-A culture positive r
ate of 20% and 24% respectively was found, an insignificant difference
. Conclusion-Small incision surgery has no proved advantage over extra
capsular surgery in terms of reducing the intraoperative bacterial ino
culum. The significance of this result in terms of causation of endoph
thalmitis is discussed.