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Hannah J Levin, Philip Storey, Maitri Pancholy, Samir N Patel, Turner D Wibbelsman, Anthony Obeid, Allen C Ho; Endophthalmitis following cataract surgery: visual outcomes and culture results. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2033.
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© ARVO (1962-2015); The Authors (2016-present)
This study describes the visual outcomes and microbial spectrum of endophthalmitis following cataract surgery (CE/IOL).
This was a retrospective case review of endophthalmitis in eyes undergoing CE/IOL between 2/1/2014 and 10/1/2017. Endophthalmitis cases identified from billing data were confirmed through medical record review. The primary outcome was mean visual acuity (VA) at baseline (time of endophthalmitis presentation), 3 months after treatment, and final follow-up. Secondary outcomes included percentage of patients with VA of 20/200 or better and microbial spectrum. LogMAR equivalents of Snellen VA were used for statistical analysis.
A total of 87 cases of post-CE/IOL endophthalmitis were included. Mean time to endophthalmitis presentation was 15 days post-CE/IOL (range 1-184 days). Mean VA at presentation was logMAR 2.14 (count fingers equivalent) and improved to logMAR 0.87 (20/160 Snellen equivalent) at 3 months (p<0.001). The percentage of patients with VA of 20/200 or better increased from 26.4% at time of presentation to 81.6% at 3 months (p<0.001).Average follow-up was 15.4 months. Mean VA at final visit was logMAR 0.93 (20/160 equivalent), significantly improved from baseline (p<0.001). The percentage of patients with VA of 20/200 or better was 73.6% at final visit, also significantly improved from baseline (p<0.001).Of the 87 cases, 43 were culture-positive (49.4%). The most commonly-isolated organisms were Staphylococcus epidermidis (n=21). Others included viridans-group Streptococci (n=8) and Staphylococcus aureus (n=7). Oral-associated bacteria were present in 8 cases (9.2%).For culture-negative cases, the mean baseline VA was logMAR 1.92 (20/1600 equivalent) and improved to 0.84 (20/125 equivalent) at final visit (p<0.001). For culture-positive cases, the mean baseline VA was logMAR 2.34 (count fingers equivalent) and improved to logMAR 1.01 (20/200 equivalent) at final follow-up (p<0.001). Mean baseline VA was significantly worse in culture-positive cases compared to culture-negative cases (p=0.02), but there was no difference between groups in final mean VA (p=0.46).
Visual outcomes following post-CE/IOL endophthalmitis improve significantly within 3 months of treatment. While culture-positive endophthalmitis is associated with worse VA at presentation, there is no significant difference in final VA between culture-negative and culture-positive groups.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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