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Rohit C. Khanna, Vanita Pathak-Ray, Madhavilatha K, Annie Mathai, S Krishnaiah, Garudadri Chandra Sekhar; Risk Factors For Endophthalmitis Following Cataract Surgery - Our Experience At A Tertiary Eye Centre In India. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5593.
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To assess the relationship between the risk factors for acute endophthalmitis after cataract extraction and whether these could be modified to decrease the risk.
We performed a nested case control study within a retrospective cohort at our Tertiary level academic practice. The surgical records of all patients with clinically diagnosed endophthalmitis within one month after cataract surgery performed between January 2006 and December 2009 were reviewed. The endophthalmitis cases were compared with controls (4 controls per case); these were randomly chosen from patients having cataract surgery within +/- 1 week of the endophthalmitis case. We performed univariate analysis to identify risk factors for endophthalmitis. Factors that were significant in univariate analysis were included in a multivariate regression analysis to further explore risk factors for endophthalmitis. Variables of interest included the cataract extraction procedure, antimicrobial prophylaxis, ophthalmic and medical history. Patient age, presence of diabetes or immunosuppression, type of cataract extraction and intraocular lens (IOL), type of anaesthesia (topical or peribulbar), type of antibiotic prophylaxis, numerical order on list, duration of surgery, surgeon experience, location of incision and intraoperative or postoperative complications were the principal variables assessed.
During the study period, 59 cases of endophthalmitis meeting our criteria were identified; 234 age and gender matched controls were then randomly selected who had cataract surgery within +/- 1 week of the endophthalmitis case. In multivariate analysis, endophthalmitis was associated with vitreous loss during surgery (odds ratio 10.52, 95% CI 3.14-35.14, p<0.0001), scleral incision (odds ratio 5.78, 95% CI 2.14-15.56, p=0.001) and acrylic intraocular lens (odds ratio 4.38, 95% CI 2.06-9.31, p<0.0001, when compared to PMMA lens)
Vitreous loss during surgery, scleral tunnel incision and acrylic intraocular implants were found to be risk factors of acute endophthalmitis following cataract surgery at our Tertiary Eye Centre.
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