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E. W. Gower, L. Zhang, A. Behrens, J. M. Tielsch, O. D. Schein; Rate of Endophthalmitis Following Cataract Surgery Among Medicare Beneficiaries in All 50 States. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5444.
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ETo estimate the rate of post cataract surgery endophthalmitis on a statewide basis across the United States.
TThe Medicare 100% sample of research identifiable data for 2003and 2004 was used to collect information on all cataract surgeries and all cases of post-cataract surgery endophthalmitis among Medicare beneficiaries. Beneficiaries were limited to a maximum of two cataract surgery claims, and a maximum of one endophthalmitis claim within the time period. Cataract surgery was defined using Current Procedural Terminology Codes 66850, 66920, 66930, 66940, 66982, 66983, and 66984. Endophthalmitis claims were limited to those claims with a diagnosis of endophthalmitis using International Disease Classification Codes 360.0-360.04 that occurred within six weeks following cataract surgery. Yearly state-based rates of endophthalmitis were calculated.
Over 1.6 million cataract surgeries were performed each year among Medicare Beneficiaries, and approximately 2000 endophthalmitis cases occurred yearly. Five states accounted for nearly 1/3 of all surgeries performed (PA, NY, CA, TX, FL). Rates of endophthalmitis varied from 0 to approximately 3 per 1000 surgeries across states. States with the highest rates of endophthalmitis varied by year; however, for both years, Tennessee and West Virginia ranked among the top 5 highest annual rates. Likewise, the states with the lowest rates varied between years. In over 2/3 of the states, the endophthalmitis rate was higher in 2003 than it was in 2004, including all five states with the highest number of surgeries.
There appear to be significant differences in endophthalmitis rates by state. Further analyses will examine variations in rate over smaller geographic areas and examine potential risk factors for higher rates.
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