To report the incidence of endophthalmitis after cataract surgery and to describe the epidemiology and main risk factors.

Patients who underwent cataract surgery in Farabi eye hospital from 2006 to 2014 were retrospectively evaluated to compare risk factors, epidemiological factors and prophylaxis methods related to endophthalmitis.

112 endophthalmitis cases in 480000 operations reported, equaling an incidence of 0.023%. Patients with diabetes mellitus (14.3%) and older ages (mean age 81 years), perioperative communication with the vitreous (17.9%), ECCE procedure (11%) and surgery on the left eye (58.9% versus 41.1% for right eye, P=0.03), showed a statistically significant association with endophthalmitis. Short-term treatment with topical or systemic preoperative antibiotics or post-operation sub conjunctival injection did not reveal statistically significant reduction in postoperative endophthalmitis, although intracameral cefuroxime reduced the rate of infection (P=0.013).

The incidence of endophthalmitis after cataract surgery in our center was 0.023% and it was acceptable in compared to other studies. It showed the older rural patients with immune suppressive disease like diabetetes mellitus are more prone to endophthalmitis, phacoemulsification and intracameral cefuroxime can reduce the risk of endophthalmitis.