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M. Parrott, H. W. Flynn, Jr., C. C. Wykoff, D. Miller, T. G. Murray, W. E. Smiddy, J. L. Davis; Nosocomial Acute-Onset Postoperative Endophthalmitis at a University Teaching Hospital (1995-2008). Invest. Ophthalmol. Vis. Sci. 2009;50(13):3557.
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To evaluate the incidence, causative organisms, and procedure performed in cases of postoperative endophthalmitis occuring within 6 weeks of intraocular surgery at a teaching hospital over the past 14 years.
A consecutive case series of acute-onset postoperative endophthalmitis cases was reviewed at a university teaching hospital between January 1, 1995 and August 31, 2008.
The overall incidence of postoperative endophthalmitis of all intraocular cases combined was 0.04%. Individually, the total was 0.04% (17/43,172) for cataract surgery and 0.04% (6/16,447) for pars plana vitrectomy (PPV). Additional cases occured following penetrating keratoplasty (4), glaucoma filtering surgery (5), and IOL exchange (1). Of the 33 total cases, the isolates were Gram positive in 21, Gram negative in 5, and culture negative in 7. The most frequent culture isolates were coagulase negative Staphylococci. Overall, a final vision of 20/200 or better was achieved in 39% of patients, but 18% had a final follow-up vision of no light perception.
At a teaching hospital environment involving resident, fellow, and faculty surgeons, the incidence of acute-onset postoperative endophthalmitis was low (0.04%) and did not increase in the era of sutureless clear cornea cataract surgery or with sutureless transconjunctival small gauge PPV. Coagulase negative Staphylococciwere the most frequently isolated pathogens from the culture-positive endophthalmitis cases. Visual outcomes remained limited with only 39% of patients with final visual acuity of 20/200 or better.
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