Endophthalmitis risk following same-day vs delayed sequential bilateral cataract surgery using the Intelligent Research in Sight (IRIS)® Registry

Abstract

Purpose : Endophthalmitis is a rare but serious postoperative complication following ocular surgery. We performed a retrospective observational study to investigate whether same-day bilateral cataract surgery is associated with increased risk of endophthalmitis.

Methods : IRIS® Registry patients who underwent cataract surgery between 2013 and 2018 were evaluated for development of endophthalmitis within two weeks of surgery. Multivariable logistic regression models were fit to assess the risk of endophthalmitis associated with same-day surgery adjusting for age, sex, insurance type, and history of common eye disease (age-related macular degeneration, diabetic retinopathy, and glaucoma) at the subject level, and to assess whether these covariates were associated with different risk of endophthalmitis between the two surgery types. Potential cases of bilateral endophthalmitis were identified and records from these patients were reviewed to confirm endophthalmitis was bilateral.

Results : There were 5,573,639 patients who underwent cataract surgery. A total of 165,609 (3%) had same-day bilateral cataract surgery and 5,408,030 (97%) had unilateral or delayed sequential bilateral surgery. A total of 3,083 (0.055%, 95%CI [0.053, 0.057]) developed postoperative endophthalmitis. Of these patients, 74 (0.045% [0.035, 0.056]) had same-day surgeries and 3,009 (0.056% [0.054, 0.058]) had unilateral or delayed bilateral surgery. Same-day bilateral cataract surgeries were not associated with increased risk of postoperative endophthalmitis (OR: 0.79 [0.60, 1.01]). The risk profile of postoperative endophthalmitis was similar between the two surgery groups (Figure). The six (0.0001%) cases of bilateral endophthalmitis that occurred were all in the delayed sequential group.

Conclusions : Rates of postoperative endophthalmitis were similar to previous literature and the rate of bilateral endophthalmitis was low. Same-day bilateral cataract surgery was not associated with increased risk of endophthalmitis after cataract surgery and did not lead to any cases of bilateral endophthalmitis.

This is a 2021 ARVO Annual Meeting abstract.

 

Odds ratios and 95% CI for risk of postoperative endophthalmitis from multivariable logistic regression models of patients who had same day vs delayed bilateral or unilateral cataract surgery.