Abstract
Purpose :
Endophthalmitis is a devastating complication of intraocular surgery; however, there is limited data on the rates of endophthalmitis in cataract surgeries combined with additional intraocular surgery. We performed a retrospective analysis to determine the incidence and characteristics of endophthalmitis for cataract surgery with a combined procedure in the United States.
Methods :
This was a retrospective analysis using 100% Medicare fee-for-service claims data for endophthalmitis after cataract surgery from 2011 to 2019. Retina surgeries included retinal detachment repair and posterior vitreous procedures; glaucoma surgeries included trabeculectomy, tube shunt implant and minimally invasive glaucoma surgery; cornea surgeries included penetrating keratoplasty, endothelial keratoplasty, and keratoprosthesis; other surgeries included anterior chamber washout, ruptured globe repair, and iridotomy. Patients with prior intraocular surgery or intravitreal injection within 3 months and diagnosis of endophthalmitis within 12 months were excluded.
Results :
19,552 cases of endophthalmitis occurred following 14,396,438 cataract surgeries from 2011 to 2019. 289,778 (2.01%) of cataract surgeries were performed with glaucoma surgery, 51,131 (0.35%) with retina surgery, 20,918 (0.15%) with cornea surgery, and 57,752 (0.40%) with other intraocular surgery. The overall rate of endophthalmitis per 1000 cataract surgeries was 1.36. Cataract surgery endophthalmitis rates per 1000 surgeries was 1.30 for cataract surgery alone, 7.33 for combined retina surgery, 2.72 for combined cornea surgery, 2.20 for combined glaucoma surgery, and 7.12 for other combined surgery. In a multivariate model, the adjusted odds ratio of endophthalmitis with combined surgery versus cataract surgery alone was 2.51 (95% CI, 2.03, 3.10) for retina surgery, 1.08 (95% CI, 0.78, 1.51) for cornea surgery, 0.78 (95% CI, 0.63, 0.97) for glaucoma surgery and 2.13 (95% CI, 1.76, 2.58) for other intraocular surgery.
Conclusions :
Rates of endophthalmitis were higher in patients who had cataract surgery with a combined procedure of cataract and retina or other intraocular surgery. These findings can improve patient counseling and future research should focus on endophthalmitis prevention in these higher risk cases.
This is a 2021 ARVO Annual Meeting abstract.