Superbugs now threatening vision recovery after cataract surgery

A study by LV Prasad Eye Institute highlights rising antimicrobial resistance in post-cataract infections, with aggressive Gram-negative bacteria resisting standard antibiotics. Nearly 8% of cases are multidrug-resistant, forcing use of last-resort drugs like Colistin, yet vision recovery remains poor

Hyderabad: Resistance to antibiotics is impacting eyes also! Yes, a growing number of cataract patients are unable to recover quickly, because of resistance to certain antibiotics.

A new multi-center study helmed by Hyderabad-based L V Prasad Eye Institute (LVPEI) has warned of the rising ‘silent threat’ of antimicrobial resistance (AMR), which is complicating recovery among cataract patients.

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Unlike the common, manageable bacteria of the past, nearly 90 percent of multidrug-resistant cases are now linked to aggressive Gram-negative bacilli. These ‘superbugs’ are increasingly showing resistance to standard frontline antibiotics, forcing doctors to turn to last-resort treatments to save the eye.

The LVPEI researchers in their study, published in the prestigious journal Retina (October, 2025), analysed post-cataract eye infection known as bacterial endophthalmitis.

While such infections, traditionally caused by common bacteria, are easily managed with standard antibiotics, the LVPEI study reported a disturbing shift where nearly eight percent of these infections are now classified as multidrug-resistant (MDR).

About 87.5 percent of these resistant cases were caused by Gram-negative bacilli, such as Pseudomonas aeruginosa. These bacteria are notoriously aggressive and have developed a biological shield against the very drugs doctors frequently prescribe to patients.

In the report, the researchers noted that nearly 40 percent of these deadly bacteria were completely resistant to the standard antibiotics for eye care , including fluoroquinolones, aminoglycosides, and cephalosporins. The study indicated that over 93 percent of patients could only perceive light or hand motions, underscoring the severity of the damage caused by these superbugs.

The researchers, however, identified Colistin, as a last resort antibiotic that continues to remain an effective alternative, which is preventing total destruction of and loss of eye among the patients.

Tragically, despite multiple surgeries and specialized injections into the eye, nearly half of the patients saw no improvement in their vision. Roughly one in ten eyes eventually developed phthisis, a condition where the eye shrivels and becomes entirely non-functional, while only a tiny fraction of patients manage to recover.

Fact Sheet

Antimicrobial resistance affects eyes also

Growing number of cataract patients not recovering with proven antibiotics

The damaged caused by the superbugs is significant

93 percent of patients in the study could only perceive light/ hand motions

India’s broader AMR crisis is fuelling this trend

OTC sale of antibiotic eye drops and frequent use of prophylactic antibiotics is allowing bacteria to evolve.