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R.A. Amankwah, N. Sarvananthan, K. Slade, E. Youngs, E.G. Hale, A.A. Castillo; Investigation Into Cluster Of Endophthalmitis Cases In An Ophthalmology Unit . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5280.
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The estimated incidence of post–operative endophthalmitis in the United Kingdom is 0.1–0.2%. Between May and September 2004, 10 cases of endophthalmitis were identified in our unit (incidence 1.25%). An investigation was carried out to establish a possible cause for the increased incidence of endophthalmitis in our unit.
A case–control study was carried out. Controls used were randomised from the database of patients having cataract surgery carried out at the same time. Five ‘time–matched controls’ were identified for each affected cases by the public health department. Data collection included information about patient factors, preoperative assessment data, intraoperative details, day of surgery, position on list, surgeon, operating theatre staff, equipment codes and postoperative details.
Each variable was looked at independently and any with p value<0.15 put into regression models. Logistic regression using forwards and backwards likelihood ratios showed similar results. Post operative topical chloramphenicol was found to be protective, relative risk = 0.1 (95% CI 0.01–0.48). Interestingly, subtyping of isolated organisms showed similar organisms on other sites e.g. nose, groin of three out of five patients.
Topical chloramphenicol post–operatively was found to be protective against endophthalmitis. A change of practice has been implemented in our department with resulting lower incidence over the next six month monitoring period.
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