Purchase this article with an account.
Amos Aranowicz, Karsten Kortuem, Martin Nentwich, Yazmin Yactayo Miranda, Anselm Kampik, Herminia Mino de Kaspar; Rate of endophthalmitis following elective cataract surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2925.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the endophthalmitis rate following posterior capsule rupture during elective catract surgery at the Department of Ophthalmology Ludwig-Maximilians University Munich and to compare these results with previously published studies.
All cases of cataract surgery between January 2005 and July 2011 were reviewed and cases where an intraoperative rupture of the posterior capsule occured were identified. A detailed analysis of those cases with regard to postoperative endophthalmitis rate, best corrected visual acuity (BCVA) before and after surgery, intra ocular pressure before and after surgery and factors like agitation of patients during surgery, PEX, vitreous loss and glaucoma was done. These data was compared with other studies. This study was approved by the local ethical review committee.
We reviewed 11,567 elective cataract surgerys and identified 173 cases where ruptures of the posterior capsule occured. The risk for a rupture of the posterior capsule was 1.50%. In all patients meticulous preoperative flush-irrigation of the cul-de-sac had been performed using 10ml 1% povidone iodine [PVI]. Median postoperative follow-up was 4 days. No cases of postoperative endophthalmitis occured in the study population. Mean preoperative BCVA was 0.37 in the right (OD) and 0.35 in the left eye (OS) while mean postoperative BCVA was 0.40 OD an 0.35 OS. Mean intraocular pressure was 14.9 mmHg OD and 14.3 mmHg and 13.9 mmHg OD and 13.8 mmHg OS after surgery. Vitreous loss occured in 80% of patients with posterior capsular rupture and agitation occured in 7.5% of cases. The rate of ruptures of the posterior capsule in other studies with larger study population was between 4.09% and 2.09%. Our incidence rate was lower (1.50%). At the same time, there was no case of postoperative endophthalmitis in our study group, while other studies published rated of postoperative endophthalmitis after cataract surgery with intraoperative rupture of the posterior capsule (0.16% respectively 0.18%).
The preoperative prophylaxis including flush-irrigation of the cul-de-sac with 10ml of PVI may have contributed to the low rates of postoperative endophthalmitis after complicated cataract surgery. Therefore we recommend to strictly adherering to a preoperative prophylaxis protocol including flush-irrigation of the conjunctiva with copious amounts of PVI.
This PDF is available to Subscribers Only