April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Nosocomial Acute-Onset Postoperative Endophthalmitis at a University Teaching Hospital (1995-2009)
Author Affiliations & Notes
  • H. W. Flynn, Jr.
    Bascom Palmer Eye Inst, University of Miami, Miami, Florida
  • C. C. Wykoff
    Bascom Palmer Eye Inst, University of Miami, Miami, Florida
  • M. B. Parrott
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • D. Miller
    Bascom Palmer Eye Inst, University of Miami, Miami, Florida
  • Footnotes
    Commercial Relationships  H.W. Flynn, Jr., None; C.C. Wykoff, None; M.B. Parrott, None; D. Miller, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 6036. doi:
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      H. W. Flynn, Jr., C. C. Wykoff, M. B. Parrott, D. Miller; Nosocomial Acute-Onset Postoperative Endophthalmitis at a University Teaching Hospital (1995-2009). Invest. Ophthalmol. Vis. Sci. 2010;51(13):6036.

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Abstract

Purpose: : To evaluate the incidence, causative organisms, and procedures performed in cases of postoperative endophthalmitis occuring within 6 weeks of all the intraocular surgeries performed at a teaching hospital over the past 15 years.

Methods: : A consecutive case series of acute-onset postoperative endophthalmitis cases was reviewed retrospectively at a university teaching hospital between January 1, 1995 and November 1, 2009.

Results: : The overall incidence of postoperative endophthalmitis of all intraocular cases combined was 0.04%. Individually, the total was 0.038% (18/47,292) for cataract surgery and 0.032% (6/18,612) for pars plana vitrectomy (PPV). Additional cases occured following penetrating keratoplasty (5), glaucoma filtering surgery (5), and IOL exchange (2). Of the 36 total cases, the isolates were Gram positive in 23, Gram negative in 5, and culture negative in 8. The most frequent culture isolates were coagulase negative Staphylococci. Overall, a final vision of 20/200 or better was achieved in 39% of patients, but 18% had a final follow-up vision of no light perception.

Conclusions: : At a teaching hospital environment involving resident, fellow, and faculty surgeons, the incidence of acute-onset postoperative endophthalmitis was low (0.04%) and did not increase in the era of sutureless clear cornea cataract surgery or with sutureless transconjunctival small gauge PPV. Coagulase negative Staphylococciwere the most frequently isolated pathogens from the culture-positive endophthalmitis cases. Visual outcomes remained limited with only 39% of patients with a final visual acuity of 20/200 or better.

Keywords: endophthalmitis • vitreoretinal surgery • cataract 
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