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J.J. Miller, H.W. Flynn, Jr, I.U. Scott, W.E. Smiddy; Acute–onset Endophthalmitis Following Cataract Surgery (2000–2004): Incidence, Risk Factors, and Outcomes . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5550.
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Purpose: To report the incidence, clinical settings, and visual acuity outcomes of acute–onset endophthalmitis following cataract surgery. Methods: Clinical and microbiologic records were reviewed of all patients who developed endophthalmitis within 6 weeks following cataract surgery performed at the Bascom Palmer Eye Institute between January 2000 and September 2004. Results: The incidence was 0.05% (7/15,405) for cataract surgeries of all methods and included 0.05% (6/11,092) by clear cornea phacoemulsification. Perioperative antibiotics were used in all patients. Six of 7 (86%) cases occurred in the right eye, and all operations were performed by right–handed surgeons through temporal incisions. Five of 7 (71%) had relative immune compromise (4 had diabetes mellitus and 1 had polymyalgia rheumatica). Four of 7 (57%) patients had vitreous loss or iris prolapse. Two patients had topical placement of lidocaine 2% gel prior to povidone–iodine. The final visual acuity was 20/25 or better in 4 patients and less than 5/200 in 3 patients. Conclusions: The incidence of acute–onset endophthalmitis after temporal clear cornea incision phacoemulsification is low (0.05%). Risk factors for endophthalmitis included inferior incision location, relative immune compromise, intraoperative complications, and application of lidocaine 2% gel prior to povidone–iodine preparation.
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