The Incidence of Endophthalmitis Following Cataract Surgery Increased Between 1994–2001

Abstract

Abstract: : Purpose:To estimate the annual incidence rate of endophthalmitis following cataract surgery, evaluate any changes in this rate over time, and examine demographic risk factors for post–surgical endophthalmitis. Methods: Medicare 5% sample beneficiary data files for inpatient and outpatient claims from 1994 through 2001 were examined to identify all cataract surgeries and subsequent cases of endophthalmitis following cataract surgery based on claims submitted. The annual rate of presumed endophthalmitis following cataract surgery was calculated, and demographic risk factors for endophthalmitis were examined using multivariate models. Results:1079 cases of presumed endophthalmitis occurred following 502,357 cataract surgeries, yielding an incidence rate of 2.15 per thousand for this eight–year period. Age–gender–race adjusted rates of endophthalmitis were significantly higher in 1998–2001 compared to earlier years (RR: 1.39; 95% CI: 1.22–1.57). Older age and black race also were associated with increased risk of endophthalmitis (RR: 1.89; 95% CI: 1.24–2.89, age 90+) and 1.42 (95% CI: 1.14–1.78), respectively). Conclusions: Analysis of Medicare claims data suggests that the rate of endophthalmitis following cataract surgery has been increasing, but does not provide an explanation for this occurrence. An increase in the rate of endophthalmitis rates is of concern, since cataract surgery is the most commonly performed operation in the United States, and the number of cataract surgeries performed annually will likely increase over the coming decades due to the aging of the U.S. population.

Keywords: endophthalmitis • cataract • clinical (human) or epidemiologic studies: outcomes/complications