IRIS Registry: Endophthalmitis After Cataract Surgery
By Lynda Seminara
Selected By: Stephen D. McLeod, MD
Ophthalmology, February 2020
Pershing et al. assessed the incidence and visual outcomes of acute-onset endophthalmitis after cataract surgery. They found that, from 2013 to 2017, the incidence of acute-onset endophthalmitis was 0.04% in the United States. The condition was much more common if cataract surgery was combined with other ophthalmic procedures.
This study involved a review of electronic health records for patients who had acute-onset postoperative endophthalmitis within 30 days of cataract surgery. Diagnosis codes were used to identify relevant cases in the IRIS (Intelligent Research in Sight) Registry database. Annual and aggregate five-year incidences were determined for all cataract surgeries, including standalone cataract procedures and cataract surgeries combined with other ophthalmic surgery. Patient characteristics were collected and compared. Mean and median visual acuity (VA) were calculated for various time points, including one month preoperatively and one week, one month, and three months postoperatively. Main outcomes were the incidence of acute-onset postoperative endophthalmitis and the visual results for affected patients.
The study population included more than 5 million patients who had cataract surgery from 2013 through 2017 in the United States (~8.5 million eyes). Acute-onset endophthalmitis occurred in 3,629 eyes (0.04%). Endophthalmitis was most common in the youngest subset (1-17 years), and it occurred in 0.20% of patients who underwent a concomitant ophthalmic surgery, versus in 0.04% of standalone cases. Among patients with anterior vitrectomy, the endophthalmitis rate was 0.35%. Three months post-op, mean VA in the endophthalmitis group was 20/100 (median, 20/50), compared with approximately 20/40 (median, 20/30) for patients without endophthalmitis. Four percent of the endophthalmitis group had VA of 20/20 or better by post-op month 3.
The authors concluded that these findings may inform point-of-care conversations with patients about risk and prognosis and can serve as a foundation for new research. Risk factors for endophthalmitis may include younger age, cataract surgery combined with other ophthalmic surgeries, and anterior vitrectomy.
The original article can be found here.