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Acute-onset endophthalmitis after cataract surgery: incidence, clinical features, causative organisms, therapy and visual outcomes

Poster Details

First Author: Y.HUANG CHINA

Co Author(s):    Y. Zhan   L. Xie           

Abstract Details



Purpose:

To evaluate the incidence, clinical features, microbiology, and therapeutic outcomes of acute-onset endophthalmitis after cataract surgery.

Setting:

Shandong Eye Institute, Qingdao, China.

Methods:

Medical records were reviewed for all patients diagnosed with acute-onset postoperative endophthalmitis from January 2006 through December 2013 associated with cataract surgery.

Results:

The 8-year frequency of acute-onset endophthalmitis was 1.26‰ after cataract surgery, 0.96‰ for extracapsular cataract extraction and 1.30‰ for clear-cornea phacoemulsification. The mean duration between cataract extraction and endophthalmitis onset was 8.7+2.1 days (range, 1 to 37 days). A percent of 65.2% of endophthalmitis occurred within 7 days. The incidence was significantly higher in summer (2.55‰) than in other seasons. The incidence was 0.57‰ in patients with combined diabetes and 1.54‰ in the non-diabetic (P=0.110). No endophthalmitis developed among patients older than 85 years. Two of the 23 patients (8.7%) were cured with antibiotic agents only. Eleven patients (47.8%) received antibiotic irrigation of the capsular bag. Six patients (26.1%) had both antibiotic irrigation of the capsular bag and intravitreal injection of antibiotics. Four patients (17.4%) were cured by vitreous surgery. Cultures were positive in 16.7% of the patients with aqueous humor samples and 26.1% of those with vitreous biopsy. The culture isolates were identified as Staphylococcus species (2 eyes), Pseudomonas paucimobilis (1 eye), Corynebacterium xerose (1 eye), Neisseria mucosa (1 eye) and Enterococcus faecalis (1 eye). The final visual acuity was 20/40 or better in 16 patients (69.6%) and worse than 20/40 but better than 20/200 in 7 patients (30.4%).

Conclusions:

The incidence of endophthalmitis in this series is comparable to larger studies. Early recognition and appropriate treatment are important in the management of acute-onset endophthalmitis after cataract surgery. FINANCIAL INTEREST: NONE

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