Etiological characteristics and related factors of infectious endophthalmitis age-related cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To explore the etiology, related factors and prevention of infectious endophthalmitis after age-related cataract surgery.<p>METHODS: A retrospective analysis of 1 365 age-related cataract patients admitted to our hospital from 2016-01/2018-01, statistics of the incidence of infectious endophthalmitis, and analysis of the pathogenic characteristics of infectious endophthalmitis and related risk factors.<p>RESULTS: Infective endophthalmitis occurred in 28 patients, and 36 pathogens were detected, including 9 strains of staphylococcus epidermidis(25.00%), 9 strains of pseudomonas aeruginosa(25.00%), and 8 strains of bacillus(22.22%). Pseudomonas aeruginosa and Bacillus have strong resistance to cefazolin, cefotaxime and amoxicillin; high sensitivity to cefoperazone-sulbactam and meropenem; staphylococcus to epidermidis erythromycin and azithromycin have strong drug resistance, and have high sensitivity to vancomycin, nitrofurantoin and minocycline. Multivariate regression analysis of Logistic, age(≥70 years), diabetes, operative time(≥15min), intraoperative vitreous spillover were independent risk factors for infectious endophthalmitis after age-related cataract surgery(<i>P</i><0.05).<p>CONCLUSION: Infectious endophthalmitis pathogens after age-related cataract surgery are more common with Staphylococcus epidermidis, Pseudomonas aeruginosa, and Bacillus. Age(≥70 years), diabetes, operative time(≥15min), intraoperative vitreous spillover were independent risk factors for infectious endophthalmitis after age-related cataract surgery.

A study on the incidence, microbiological analysis and investigations on the source of infection of postoperative infectious endophthalmitis in a tertiary care ophthalmic hospital: An 8-year study.

Background: The objective of the study was the determination of the incidence of culture-proven postoperative endophthalmitis and probable sources of infection. Materials and Methods: It was a prospective study on the microbiology, incidence and probable sources of infection in patients with postoperative infectious endophthalmitis carried out in a tertiary care eye hospital. Consecutive patients diagnosed with postoperative infectious endophthalmitis during the years 2000-2007 were investigated for the causative infective agent and possible sources of infection. The surgical data and microbiological data including the investigations performed to trace the source were recorded in a specific formatted form and were gathered and compiled for analysis. Results: Data of analysis showed that 98 (0.042%) out of 2,31,259 patients who underwent intra-ocular surgery developed infectious endophthalmitis. Among these, 70 (0.053%) occurred after cataract, 10 (0.5%) after penetrating keratoplasty (PK) and 18 (0.018%) following other types of intra-ocular surgeries. The predominant infectious agents isolated were bacteria (89.7%), with equal proportions of Gram-positive and Gram-negative bacteria. Polymicrobial infection was noted in four and fungi in seven patients. Occurrence of postoperative endophthalmitis was sporadic and not related to any specific part of period in a year. Sources of infection were donor corneal rim in six post-PK patients and phaco probe in one who had postphacoemulsification endophthalmitis Conclusions: Overall incidence of postoperative endophthalmitis over an 8-year period was quite low. The sources of infection could be established in six post-PK endophthalmitis patients and in a postcataract surgery.

Infectious Endophthalmitis After Intravitreal Injection of Triamcinolone Acetonide

PURPOSE: We report 2 cases of infectious endophthalmitis after intravireal triamcinolone acetonide injection which was successfully treated with early vitrectomy. METHODS: A 56 year old male patient with chronic cystoid macular edema of right eye and an 84 year old female patient with diabetic macular edema of right eye (pseudophakic) eye were treated with intravireal triamcinolone acetonide injection. Four days after the injection, both the patients complained of decreased visual acuity that had been developed 1 and 2 days prior respectively. Visual acuity was hand motion, inflammatory cells, flare, fibrins and hypopyon were found in the anterior chamber. Fundus was not visible due to vitreous opacity. RESULTS: The two patients were presumed to have infectious endophthalmitis. Anterior chamber irrigation, vitrectomy, intravitreal antibiotics injection, and vitreous culture were performed. Coagulase negative staphylococcus was detected from vitreous culture, Within 1 week of the follow-up procedures, the anterior chamber and vitreous inflammation were improved and visual acuity recovered to the level attained before intravireal triamcinolone acetonide injection. CONCLUSIONS: If after intravireal triamcinolone acetonide injection, there is severely decreased visual acuity, inflammation of the anterior chamber and vitreous, flare and fibrin are detected, infectious endophthalmitis must be suspected. If diagnosed early and treated with vitrectomy, a favorable visual prognosis is expected.