Comparative Trends And Management Patterns Of Acute Postoperative And Endogenous Endophthalmitis: A 10-Year Nationwide Study
Published 2026 - 44th Congress of the ESCRS
Reference: FP20.05 | Type: Free paper | DOI: 10.82333/kkc7-r572
Authors: Dr Woojin Kim* 1 , Chan Mi Park 2 , A/Prof. Dong Hyun Kim 3 , A/Prof. Youngsub Eom 4 , A/Prof. Jong Suk Song 1
1Department of Ophthalmology,Korea University Guro Hospital,Seoul,Korea, Republic Of, 2Biomedical Research center, Korea University Guro Hospital,Seoul,Korea, Republic Of, 3Department of Ophthalmology,Korea University Anam Hospital,Seoul,Korea, Republic Of, 4Department of Ophthalmology,Korea University Ansan Hospital,Ansan, Gyeonggi-do,Korea, Republic Of
Purpose
To evaluate nationwide temporal trends and management patterns of acute postoperative endophthalmitis (APE) and endogenous endophthalmitis (EE) over a 10-year period, with particular focus on the evolving contribution of intravitreal injections (IVI).
Setting
Nationwide retrospective cohort study using the Korean National Health Insurance database, covering the entire population from 2013 to 2022.
Methods
Patients diagnosed with APE or EE between 2013 and 2022 were identified and categorized based on preceding cataract surgery, IVI, or systemic infection. Demographics, Charlson Comorbidity Index (CCI), treatment modality (intravitreal antibiotics vs pars plana vitrectomy), and outpatient follow-up duration were analyzed. Temporal trends were assessed annually.
Results
A total of 8,274 cases were identified (7,625 APE; 649 EE). The proportion of IVI-related APE increased markedly from 13.1% to 26.2% during the study period. Overall APE incidence fluctuated, with a transient peak in 2020 associated with a fungal outbreak. EE incidence remained relatively stable. EE patients had higher systemic comorbidity (mean CCI 3.6 vs 1.2) and longer outpatient follow-up (269 vs 67 days). Pars plana vitrectomy was more frequently performed in EE.
Conclusions
Cataract surgery remained the leading antecedent of APE; however, the relative contribution of IVI increased substantially over time. EE carried greater systemic comorbidity and treatment burden. These findings underscore the need for strengthened infection control in intravitreal procedures and tailored management strategies according to etiology.