Incidence and visual outcome of acute endophthalmitis after cataract surgery—the experience of an eye department in Scotland

Abstract

Aim: Endophthalmitis remains one of the most dreaded complications of modern cataract surgery. Its incidence in the UK has been estimated but accurate published data on the incidence at a regional level are scarce. This audit examines the incidence and visual outcome of endophthalmitis from a single eye department in Scotland (UK) over a 7-year period. Findings are compared with those from other series.

Methods: A retrospective consecutive audit of all cases of acute endophthalmitis treated between 1 January 2000 and 31 December 2006 at the Southern General Hospital in Glasgow (Scotland, UK) was undertaken. Details of each case (presentation, treatment and outcome of endophthalmitis) were recorded. Cross-tabulations were performed to identify prognostic factors of visual outcome.

Results: Twenty-five patients were treated for endophthalmitis over the audit period. The incidence of endophthalmitis was 0.20% (95% CI 0.10 to 0.30%). There were 12 (48%) culture-positive cases with coagulase-negative staphylococcus accounting for 58%. After treatment, 16 patients (64%) achieved driving-standard vision or better. Poor vision at presentation and streptococcal endophthalmitis were associated with poor visual outcome.

Conclusion: The incidence of endophthalmitis in this series is comparable to larger studies, suggesting that accepted benchmarks, despite being estimates, reflect UK practice. Visual outcome, with treatment, can be favourable in a significant proportion of patients.