Abstract
Purpose :
Endophthalmitis after cataract surgery is a vision-threatening but rare event with an incidence of ~0.5 to 3 per 1,000, thus necessitating a large sample size to conduct meaningful studies. As of Sep. ‘20, the IRIS® Registry (Intelligent Research in Sight) includes data from >60 M (million) unique patients, making it an ideal data source to assess rare events. Hydrogel Sealant (ReSure Sealant) creates an in situ temporary soft surface barrier to prevent wound leakage of any clear corneal incision after cataract surgery. Here, we evaluate the incidence of endophthalmitis following any cataract surgery (routine or complex) between sites with and without access to ReSure Sealant.
Methods :
This retrospective study analyzed patient data from the IRIS Registry from Jan 1, 2016 to Dec 1, 2019 on the incidence of endophthalmitis following cataract surgery in practices with & without access to hydrogel sealant. Inclusion criteria for patients included having cataract removal via phacoemulsification with intraocular lens insertion, ≥1 visits within 30 days after surgery, & being at least 22 years. Practices must have provided data for at least 30 days after each surgery.
Results :
Approximately 6 M eyes of 4 M patients were eligible for inclusion. Mean age was 70.91 (SD: 8.95). Overall endophthalmitis incidence was 0.644 (all incidence rates calculated per 1,000 cataract surgeries; 95% Confidence Interval: 0.625, 0.663). Endophthalmitis rate at practices with ReSure Sealant access was 0.619 (0.59, 0.64) vs. without 0.671 (0.64, 0.7) (P=0.01). Endophthalmitis rate (87% cases) after routine cataract procedures was 0.582 (0.56, 0.61) at practices with Sealant access vs. without 0.625 (0.60, 0.65) (P=0.03). Endophthalmitis rate (13% cases) after complex cataract procedures at practices with Sealant access was 1.097 (0.97, 1.22) vs. without 1.227 (1.09, 1.37) (P=0.18).
Conclusions :
To our knowledge, this is the largest reported recent review of endophthalmitis cases after cataract surgery. Overall endophthalmitis rate was low (0.644 per 1,000 cataract surgeries). Patients undergoing complex cataract surgery had a higher incidence of endophthalmitis. Sites with access to ReSure Sealant a had statistically significant lower rate of endophthalmitis than sites without access. This difference was not clinically meaningful.
This is a 2021 ARVO Annual Meeting abstract.