Subject(s)
Emigrants and Immigrants , Endophthalmitis/microbiology , Eye Infections, Bacterial/microbiology , Klebsiella Infections/microbiology , Klebsiella pneumoniae/isolation & purification , Vitreous Body/microbiology , Diagnosis, Differential , Endophthalmitis/diagnosis , Endophthalmitis/ethnology , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/ethnology , Humans , Klebsiella Infections/diagnosis , Klebsiella Infections/ethnology , Male , Middle Aged , Ontario/epidemiology , Tomography, X-Ray Computed , Vietnam/ethnologyABSTRACT
PURPOSE: To investigate the rate of bleb-related endophthalmitis over 5 years in a Chinese population. METHODS.:Retrospective chart review. RESULTS: Of 988 trabeculectomies performed over 5 years, one case (0.1%) developed early endophthalmitis caused by Morganella morganii, which was rarely reported in the literature. Six cases (0.6%) developed late-onset endophthalmitis. Mitomycin C significantly increased the risk of late-onset endophthalmitis (p=0.0002). CONCLUSIONS: Physicians should weigh the benefits against the risks of mitomycin C application in performing trabeculectomies.
Subject(s)
Endophthalmitis/microbiology , Eye Infections, Bacterial/microbiology , Postoperative Complications , Trabeculectomy , Adult , Aged , Alkylating Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Asian People/ethnology , China/epidemiology , Drug Therapy, Combination , Endophthalmitis/drug therapy , Endophthalmitis/ethnology , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/ethnology , Enterobacteriaceae Infections/microbiology , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/ethnology , Female , Glaucoma/surgery , Humans , Male , Middle Aged , Mitomycin/administration & dosage , Morganella morganii/isolation & purification , Retrospective Studies , Staphylococcal Infections/drug therapy , Staphylococcal Infections/ethnology , Staphylococcal Infections/microbiology , Staphylococcus aureus/isolation & purification , Streptococcal Infections/drug therapy , Streptococcal Infections/ethnology , Streptococcal Infections/microbiology , Viridans Streptococci/isolation & purification , Vitreous Body/microbiologySubject(s)
Asian People/statistics & numerical data , Endophthalmitis/ethnology , Eye Infections, Bacterial/ethnology , Postoperative Complications , Acute Disease , Anti-Bacterial Agents , Cataract Extraction/statistics & numerical data , Drug Therapy, Combination/therapeutic use , Endophthalmitis/drug therapy , Endophthalmitis/microbiology , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/microbiology , Humans , Incidence , Singapore/epidemiologyABSTRACT
OBJECTIVE: To describe the incidence, risk factors, and clinical outcome of acute endophthalmitis after cataract extraction in a multiethnic Asian population. DESIGN: Prospective case series. PARTICIPANTS: All patients with cataract extractions performed at the Singapore National Eye Center from 1996 to 2001. METHODS: Data on patients with acute endophthalmitis cases presenting within 6 weeks after cataract surgery were prospectively collected in a standardized format. MAIN OUTCOME MEASURES: Acute endophthalmitis after cataract surgery. RESULTS: During the study period, 44 803 cataract operations (25 476 phacoemulsification and 19 327 extracapsular cataract extractions) were performed. There were 34 cases of acute endophthalmitis (average annual incidence of 0.076%), 21 of which were culture positive (average annual incidence of 0.040%). In multivariate analysis, risk of endophthalmitis was associated with phacoemulsification technique (relative risk [RR], 1.9; 95% confidence interval [CI], 0.9, 3.9; P = 0.10 for all endophthalmitis cases; RR, 3.1; 95% CI, 1.1, 9.4; P = 0.04 for culture-positive endophthalmitis cases) and the occurrence of intraoperative posterior capsule rupture (RR, 8.0; 95% CI, 3.1, 20.7; P<0.001 for all endophthalmitis cases; RR, 11.0; 95% CI, 3.7, 23.9; P<0.001 for culture-positive endophthalmitis cases). After a median follow-up of 234 days, half of the eyes achieved a final best-corrected visual acuity of 20/40. Predictors of this visual acuity included baseline acuity of counting fingers or better, culture-negative endophthalmitis, or infection caused by coagulase-negative Staphylococcus. CONCLUSION: The incidence of acute endophthalmitis after cataract extraction in Singapore is consistent with rates reported elsewhere. The phacoemulsification technique is associated with a higher risk of acute culture-positive endophthalmitis compared with extracapsular cataract extraction. Intraoperative posterior capsule rupture is associated with an 8- to 11-fold higher risk of acute endophthalmitis, suggesting that these eyes should be closely monitored for signs of infection in the immediate postoperative period.
Subject(s)
Asian People/statistics & numerical data , Cataract Extraction/statistics & numerical data , Endophthalmitis/ethnology , Eye Infections, Bacterial/ethnology , Postoperative Complications , Acute Disease , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents , Cataract Extraction/methods , Drug Therapy, Combination/therapeutic use , Endophthalmitis/microbiology , Endophthalmitis/therapy , Eye Infections, Bacterial/microbiology , Eye Infections, Bacterial/therapy , Female , Humans , Incidence , Male , Middle Aged , Prospective Studies , Risk Factors , Singapore/epidemiology , Treatment Outcome , Visual Acuity , VitrectomyABSTRACT
AIM: To describe risk factors of acute endophthalmitis after cataract extraction in an Asian population. METHODS: A retrospective, case-control study. Cases (n = 34) were patients with acute endophthalmitis presenting within 6 weeks after cataract surgery. Three controls per case (n = 102) were randomly selected from the cataract surgery list matched on the date of operation of cases. RESULTS: Few risk factors were identified. In multivariable analysis, endophthalmitis was associated with silicone intraocular lens (odds ratio 5.1, 95% confidence intervals, 1.2 to 21.6, compared to poly(methylmethacrylate) lens) and posterior capsular rupture during surgery (odds ratio 20.9, 95% confidence intervals 2.3 to 187.9). CONCLUSION: Silicone intraocular lens and rupture of the posterior capsule are risk factors of acute endophthalmitis after cataract surgery.
