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  • IRIS Registry: Endophthalmitis After Cataract Surgery

    By Lynda Seminara
    Selected By: Stephen D. McLeod, MD

    Journal Highlights

    Ophthalmology, February 2020

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    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.