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  • Cataract/Anterior Segment

    Review of: Endophthalmitis rates among Medicare beneficiaries undergoing cataract surgery between 2011 and 2019

    Zafar S, Dun C, Srikumaran D, et al. Ophthalmology, March 2022

    Investigators conducted this study to determine the incidence of endophthalmitis in the United States as well as the associated risk factors in developing endophthalmitis following cataract surgery.

    Study design

    This was a cross-sectional, retrospective, national database study involving more than 14 million cataract surgeries in patients aged ≥65 years. The data were pulled from Medicare claims between 2011 and 2019.


    The overall rate of endophthalmitis cases in the 90 days after cataract surgery during the 2011–2019 period was 1.36/1000 surgeries. However, case rates were seen to decrease over time, from 1.53/1000 surgeries in 2012 to 1.11/1000 surgeries in 2019. Male gender, age ≥75 years, and Black and Native American ethnicity were risk factors for developing endophthalmitis. Eyes that had undergone invasive glaucoma surgery and those which had concomitant retinal and cataract surgeries also were at risk.


    The greatest limitation of this study is that the claims are based only on an administrative database and billing records, not clinical records.

    Clinical significance

    Cataract surgery is the most commonly performed surgery in the United States; therefore, it is imperative to be able to assess the risks of the procedure. This study allows clinicians to be able to ascertain the risk factors for their patients and clearly portrays the true risk of the devastating complication of endophthalmitis. While the 1.36/1000 infection complication rate is good, ophthalmologists should work to continue to lower the rate, in keeping with the trends seen over time in this study. With the advent of intracameral antibiotics, this rate may continue to trend downward.

    Financial Disclosures: Dr. Michael Patterson discloses financial relationships with Allergan (Consultant/Advisor); Carl Zeiss Meditec (Consultant/Advisor); Glaukos Corporation (Consultant/Advisor); Iantech (Consultant/Advisor); Johnson & Johnson Vision (Consultant/Advisor); New World Medical (Consultant/Advisor).