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N. Morlet, J. Li, J.Q. Ng, J.B. Semmens, teamEPSWA; Non–surgical risk factors for endophthalmitis after cataract surgery . Invest. Ophthalmol. Vis. Sci. 2004;45(13):511.
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Purpose: Despite significant changes to surgical practice, endophthalmitis remains a devastating complication of cataract and other ocular surgery. Previous research into endophthalmitis after cataract surgery has tended to focus on operative risk factors. Studies were also often limited to single or small groups of centres and/or surgeons thereby potentially reducing external generalisability. Methods: Using the Western Australian Data Linkage System we conducted a study of endophthalmitis in an entire, geographically defined population from 1980 to 2000. Cases of endophthalmitis were verified by medical record review and cross–referencing with other sources. Multivariate logistic regression modelling was used to characterise risk factors of interest. Results: There were 210 cases of endophthalmitis occurring after 117,083 operations, an incidence of 0.18%. Endophthalmitis was significantly associated with patients over 80–years (OR 1.50, 95% CI 1.13–1.99), operations in private hospitals (OR 2.38, 95% CI 1.32–4.27), same–day surgery (CI 1.62, 95% CI 1.01–2.61), and to a lesser extent winter operations (OR 1.48, 95% CI 1.00–2.18). A lacrimal or eyelid procedure during the same admission as cataract surgery dramatically increased the risk of endophthalmitis (OR 23.50, 95% CI 8.50–64.98). Conclusions: By adopting a systematic approach to the management of older patients, length of hospital stay and clinical protocols, it may be possible to reduce the incidence of endophthalmitis after cataract surgery by almost 80%.
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