RT Journal Article
SR Electronic
T1 The incidence of postoperative endophthalmitis after cataract surgery in China: a multicenter investigation of 2006–2011
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 1312
OP 1317
DO 10.1136/bjophthalmol-2013-303282
VO 97
IS 10
A1 Ke Yao
A1 Yanan Zhu
A1 Zhihong Zhu
A1 Jianjun Wu
A1 Yizhi Liu
A1 Yi Lu
A1 Yansheng Hao
A1 Yongzhen Bao
A1 Jian Ye
A1 Yusen Huang
A1 Zhaohui Li
A1 Xingchao Shentu
A1 Yibo Yu
YR 2013
UL http://bjo.bmj.com/content/97/10/1312.abstract
AB Aims To estimate the cumulative incidence of postoperative endophthalmitis, identify risk factors and determine clinical outcomes in China. Methods Medical records were reviewed for all patients with acute-onset endophthalmitis after cataract surgery from January 2006 to December 2011 at eight eye centres of tertiary care hospitals in China. Results Sixty-six cases of presumed endophthalmitis occurred after 201 757 cataract surgeries, yielding a cumulative incidence of 0.033% (95% CI 0.025 to 0.041). Logistic regression analysis revealed that the risk of endophthalmitis increased with intraoperative communication with vitreous (multivariate OR 9.96; 95% CI 4.54 to 21.84; p<0.001). After a median follow-up of 153 days, best-corrected visual acuity in the affected eye was more than 20/70 in 29/65 (44.6%) patients, and more than 20/40 in 20/65 (30.8%). A predictor of good visual acuity was baseline acuity of counting fingers or better (OR 6.25; 95% CI 2.13 to 18.33). Of 64 cases, 25 (39.1%) were culture positive. Coagulase-negative Staphylococcus and Pseudomonas species were the most common organisms isolated, accounting for 72.0% of the culture-positive cases (18/25). Two eye centres that used a combination of a high concentration vancomycin (1 mg/0.1 mL intracameral vancomycin injection or 100 µg/mL vancomycin in irrigating solution) and tobramycin as infection prophylaxis achieved a lower incidence of endophthalmitis than other centres (p<0.001). Conclusions The incidence of acute postoperative endophthalmitis after cataract surgery in tertiary care hospitals of China was 0.033%. Intraoperative communication with vitreous was a major risk factor for developing endophthalmitis. Prophylactic use of a high-concentration vancomycin and tobramycin may play a positive role in the prevention of postoperative endophthalmitis after cataract surgery.