Incidence and clinical behavior of endophthalmitis post cataract surgery

Abstract

Introduction: Postoperative endophthalmitis is the most feared complication of cataract surgery. It is potentially devastating, can seriously threaten vision and has an estimated incidence of between 0.02 and 0.71%.

Objective: To determine the incidence of endophthalmitis after cataract surgery and its clinical behavior.

Methods: An observational, descriptive, cross-sectional, descriptive study was performed. Thirteen 850 consecutive cataract surgeries performed at the Ophthalmologic Center of the Clinical Surgical University Hospital "Arnaldo Milián Castro" of Villa Clara were reviewed.

Results: The incidence of endophthalmitis after cataract surgery in this series was 0.17% (95% CI: 0.10-0.24%); 0.18% (95% CI: 0.11-0.25%) for extracapsular extraction of the crystalline lens and no incidence in phacoemulsification. The acute form of presentation was more frequent than the chronic form; 0.13 % (95 % CI: 0.07-0.19 %) and 0.04 % (95 % CI: 0.01-0.07 %), respectively. Males were more affected than females and the mean age was 71.8 years. The acute form occurred with a mean of 5.1 days between surgery and symptom onset and the chronic form with a mean of 21.2 weeks. Thirty-nine.1 % of patients had visual acuity of light perception at the time of diagnosis. Bacterial growth was reported in 44.7 % of the specimens, with positivity in aqueous and vitreous humor of 42.1 % and 47.4 %, respectively. Coagulase-negative Staphylococcus was the most frequent germ. Intravitreal antibiotics plus remission for early flat vitrectomy was the most commonly employed therapeutic behavior.

Conclusions: The incidence of post cataract surgery endophthalmitis in this series is in the range of that reported worldwide. It commonly presents acutely and with poor visual acuity. The most frequently isolated etiologic agent was coagulase-negative Staphylococcus.