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Is combined cataract surgery associated with acute postoperative endophthalmitis? A nationwide study from 2005 to 2014
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    RE: Is combined cataract surgery associated with acute postoperative endophthalmitis? A nationwide study from 2005 to 2014
    • R. Rishi Gupta, Ophthalmologist Dalhousie University, Halifax, NS, Canada
    • Other Contributors:
      • Mark E. Seamone, Ophthalmologist
      • Marcelo Nicolela, Ophthalmologist
      • Jayme R. Vianna, Ophthalmologist
      • Daniel M. O'Brien, Ophthalmologist

    Dear Editor,

    We read with interest the article written by Creuzot-Garcher and colleagues that was published in the June 2018 issue of your journal. 1 The authors retrospectively reviewed billings codes from a national database in France from January 2004 to December 2014 to examine acute postoperative endophthalmitis (POE) rates. They reported an incidence of acute POE in stand-alone phacoemulsification of 0.102% over this 11-year period. In contrast, combined surgery in which phacoemulsification was performed with another intraocular procedure had an overall higher incidence of 0.149%. The incidence of acute POE in combined phacoemulsification and glaucoma surgery, corneal surgery, and vitreoretinal surgery was found to be 0.089%, 0.142%, and 0.223% respectively.

    As Creuzot-Garcher and colleagues mention, many phakic patients who undergo either glaucoma surgery, corneal surgery, or vitreoretinal surgery, are elderly and likely will require cataract extraction at some point.1 In addition, it is well established that these surgeries promote cataract formation in phakic eyes, and therefore patients who do not undergo combination surgery will likely require stand-alone cataract surgery in the future.

    Hence, it would be instructive to compare the risk of acute POE in combined surgery with the total risk conferred by separately performing the two surgeries. We made the assumption that the chance of endophthalmitis in each surgery is independent. Using the...

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    Conflict of Interest:
    None declared.