Abstract
Purpose :
Published rates of endophthalmitis and toxic anterior segment syndrome (TASS) vary in the literature. Due to rarity and hesitation to report, there is a gap in understanding of occurrences of these conditions. We performed a retrospective data analysis of endophthalmitis and TASS rates at a high volume ophthalmic only ambulatory surgery center (ASC).
Methods :
We gathered data from the ASC from 2016 to September 2021 for endophthalmitis and from 2009 to September of 2021 for TASS. Surgeries were organized into anterior segment (referring to cataract surgery, glaucoma surgery, and cornea surgery) as well as posterior segment surgery (referring to retina surgery only) relative to case volume. Only intraocular surgeries were counted. Laser surgeries as well as oculoplastic surgeries were excluded. Additionally, we analyzed the responsible organisms by type and gram stain.
Results :
The overall rate of endophthalmitis was 0.12% (36 out of 32,051 intraocular surgeries). For anterior segment surgeries, the rate of endophthalmitis was 0.10% (21 out of 21,138). For posterior segment surgeries, the rate of endophthalmitis was 0.14% (16 out of 11,513). The p value using a student’s t-test between anterior and posterior segment total cases of endophthalmitis was not statistically significant (P=0.517) nor was the case rate statistically significant (P=0.380). The most common gram positive organism was staphylococcus epidermidis, and the most common gram negative organism was serratia marcescens. The p value using a student’s t-test between gram positive and gram negative organisms was significant for both surgery types favoring gram positive (P=0.045 for anterior segment and 0.042 for posterior segment). The rate of TASS from the years recorded per total number of cases was 0.073%.
Conclusions :
The rate of endophthalmitis between anterior and posterior segment surgeries was not statistically significant. This information is clinically significant for several reasons. When discussing risks during the pre-operative visit, one can more accurately describe the risk. Additionally, this has led to introspection and changed practices regarding sanitation at the surgery center. The rate of TASS was low without a single case most years.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.