Endophthalmitis, A 10-Year Retrospective Review At A Monographic Eye Hospital

Published 2022 - 40th Congress of the ESCRS

Reference: PP04.10 | Type: ESCRS 2022 - Posters | DOI: 10.82333/t22k-8w82

Authors: Jose Vicente Piá Ludeña* ¹ , Santiago Montolío Marzo ¹ , Guillermo Rodríguez Iranzo ¹ , Aitor Lanzagorta Aresti ¹ , Cristina Peris Martínez ¹ , Ester Fernández López ¹

¹Fisabio-Oftalmología Médica,Valencia,Spain

Purpose

To review the cases of endophthalmitis after cataract surgery at a tertiary/monographic eye hospital and compare its incidence, complication rates, and antibiotic prophylaxis with previously published reports.

Setting

Fisabio Oftalmología Médica, Valencia, Spain

Methods

Retrospective chart review of patients who underwent cataract surgery between January 1, 2011, and January 1, 2021, at Fisabio Oftalmología Médica, Valencia, Spain.

We analyzed preoperative risk factors, intraoperative and postoperative complications, infectious organism identified, antibiotic resistance, antibiotic treatment choice and visual acuity. Endophthalmitis surgeries other than cataract surgery were excluded. Our endophthalmitis prophylaxis protocol included preoperative povidone iodine instillation, intraoperative intracameral cefuroxime and moxifloxacin drops (5 times a day during 1 week postoperatively).

Results

14 patients developed endophthalmitis after cataract surgery, out of 53.755 cataract surgeries performed. Our overall incidence of postoperative endophthalmitis over this 10-year period was 0,026%.

In most cases, endophthalmitis were associated with intra and postoperative surgical complications, 42% and 14% respectively. The average occurrence time was 11,35 days. Microbial cultures were positive in 71,7% of cases. Among positive cultures, 80% were Gram-positive cocci, out of which 30% were cefuroxime-resistant strains.

All patients received intravitreal injection of ceftazidime and vancomycin. In addition, 12 patients underwent pars plana vitrectomy within the first 24 hours.

Conclusions

Postoperative endophthalmitis is one of the most dangerous complications after cataract surgery. Despite early treatment, endophthalmitis has devastating consequences in visual function, so prevention strategies are fundamental.

Our incidence of endopthalmitis after cataract surgery was 0,026% from 2011 to 2021, showing a lower rate than previous reports. Our findings suggest the importance of combining different intracameral and topic antibiotics in addition to preoperative cleansing with povidone-iodine in order to enhance antimicrobial safety.

The development of endophthalmitis is closely related to surgical complications, so it is advisable to closely follow-up these patients.