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H.W. Flynn, Jr., J.J. Miller, I.U. Scott, W.E. Smiddy, T.G. Murray, D. Miller; Acute–Onset Endophthalmitis Following Cataract Surgery in a University Teaching Hospital (2000–2005) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5293.
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© ARVO (1962-2015); The Authors (2016-present)
To report the incidence, clinical settings, and visual acuity outcomes of acute–onset endophthalmitis following cataract surgery.
In this retrospective, observational case series, annual cataract surgery statistics were determined by review of electronic surgical records. The clinical and microbiologic records were reviewed of all patients with clinically diagnosed endophthalmitis within 6 weeks following cataract surgery at a single university–affiliated hospital between January 2000 and September 2005. Povidone–iodine preparation of the lids, lashes, and conjunctiva was performed in all cases. Topical antibiotics were used at the discretion of the individual cataract surgeon. Both culture positive and culture negative cases were included. Cataract surgeries which were combined with any other procedure, including penetrating keratoplasty, pars plana vitrectomy, or trabeculectomy, were excluded from the study. Patients with delayed–onset endophthalmitis (infection diagnosed greater than 6 weeks after surgery) and endophthalmitis referred to the Bascom Palmer Eye Institute following cataract surgery performed elsewhere were also excluded.
The incidence of acute–onset endophthalmitis following cataract surgery was 0.04% (8/18,863) for cataract surgeries of all methods, 0.05% (7/13,581) for cataract surgery by clear cornea phacoemulsification, and 0.02% (1/5,282) for cataract surgery by methods other than clear cornea phacoemulsification. Seven of 8 (88%) cases occurred in the right eye, and all cases were performed by right–handed surgeons through temporal incisions. Five of 8 (63%) patients had relative immune compromise. Four of 8 (50%) patients had an intraoperative complication: vitreous loss in 3 patients and iris prolapse in one patient. One patient had severe blepharitis treated preoperatively with tetracycline. The visual acuity at final follow up was 20/30 or better in 5 patients and count fingers or worse in 3 patients.
The incidence of acute–onset endophthalmitis after temporal clear cornea incision phacoemulsification is low (0.05%). Potential risk factors for endophthalmitis may include intraoperative complications, relative immune compromise, blepharitis, and inferior incision location.
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