June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Acute-Onset Postoperative Endophthalmitis After Cataract Surgery Performed by Resident and Attending Physicians at a University Teaching Hospital (2015-2020)
Author Affiliations & Notes
  • Harry W Flynn
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Anne L Kunkler
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Kendall E Donaldson
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Darlene Miller
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Nicolas A. Yannuzzi
    Ophthalmology, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Harry Flynn, None; Anne Kunkler, None; Kendall Donaldson, Alcon (C), Carl Zeiss Pharmaceuticals (C), Eyevance (C), Johnson and Johnson (C), Kala Pharmaceuticals (C), Tissue Tech (C); Darlene Miller, None; Nicolas Yannuzzi, Alimera Sciences (C), Genentech (C), Novartis (C)
  • Footnotes
    Support  Bascom Palmer Eye Institute receives funding from NIH Center Core Grant P30EY014801 (Bethesda, Maryland), Research to Prevent Blindness Unrestricted Grant (New York, New York), Department of Defense Grant #W81XWH-09-1-0675 (Washington, DC)
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1359. doi:
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      Harry W Flynn, Anne L Kunkler, Kendall E Donaldson, Darlene Miller, Nicolas A. Yannuzzi; Acute-Onset Postoperative Endophthalmitis After Cataract Surgery Performed by Resident and Attending Physicians at a University Teaching Hospital (2015-2020). Invest. Ophthalmol. Vis. Sci. 2021;62(8):1359.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate nosocomial acute-onset postoperative endophthalmitis following cataract surgery at a university teaching hospital and to compare frequency among resident and attending physicians.

Methods : This study was a retrospective, consecutive case series of patients diagnosed with acute-onset postoperative endophthalmitis within 6 weeks of cataract surgery performed at at Bascom Palmer Eye Institute, Miami, Florida between January 1, 2015, and November 30, 2020. Resident physician case totals were obtained from self-reported case logs.

Results : In a six-year period, there were 22 cases of acute-onset postoperative endophthalmitis following cataract surgery at a single institution. The overall frequency of endophthalmitis was 0.068% (22/32,505). The most common bacterial isolate was Coagulase-negative Staphylococcus (7/22, 31.8%) followed by Streptococcus spp. (3/22, 13.6%). Cultures were negative in 11 eyes (11/22, 50%). Initial treatment with tap and injection was performed in 21 eyes (21/22, 95.4%) and vitrectomy in one eye (1/22, 4.5%). Injection of vancomycin 1.0mg and ceftazidime 2.25mg was performed in all eyes and dexamethasone 400ug was added initially in 18 eyes (18/22, 81.8%). Vitrectomy was performed as a second treatment in 9 patients (9/22, 40.9%). Visual acuity (VA) at last follow up was 20/40 or better in 13 eyes (13/22, 59%) and hand motions or worse in 3 eyes (3/22, 13.6%). The frequency of endophthalmitis for resident physicians was 0.09% (6/6,447), compared to 0.06% (16/26,058) for attending physicians, but this difference was not statistically significant (P=0.55). There was no difference (P=0.14) between average VA outcomes among resident (logMAR VA 1.19 ± 1.06) and attending physican (logMAR VA 0.53 ± 0.80) cases.

Conclusions : At a university teaching hospital, the frequency of acute-onset postoperative endophthalmitis following cataract surgery remains low. When stratified between resident and attending physicians, the frequency of endophthalmitis and visual outcomes were similar.

This is a 2021 ARVO Annual Meeting abstract.

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