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International Ophthalmology
Published in: International Ophthalmology 1/2020

01-01-2020 | Cataract | Original Paper

Endophthalmitis after intravitreal injections versus cataract surgery: a 15-year cohort

Authors: Nimrod Dar, Shani Pillar, Asaf Friehmann, Avner Belkin, Shay Ofir

Published in: International Ophthalmology | Issue 1/2020

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Abstract

Purpose

To compare the clinical features, visual outcomes and causative organisms between endophthalmitis secondary to cataract surgery or to intravitreal injections (IVI).

Setting

Meir Medical Center, Kfar Saba, Israel.

Design

Retrospective, non-randomized comparative chart review.

Methods

Medical records of patients with proven or suspected endophthalmitis admitted to the Ophthalmology Department at Meir Medical Center 2/2002–2/2017 were reviewed. Clinical characteristics including presenting and final visual acuity (VA) outcomes, causative organisms and time to admission were assessed.

Results

Among 84 patients in our study, 35 had preceding cataract surgery and 12 had preceding IVI. The post-cataract group showed a significant improvement in VA following treatment with a presenting and final VA (logMar ± SD) of (1.80 ± 0.54 and 1.39 ± 0.65, P < 0.01) as opposed to the post-IVI group (1.72 ± 0.26 and 1.81 ± 0.32, P = 0.692), while most patients in the cataract group exhibited some degree of VA recovery (70.96%). Patients undergoing cataract surgery were divided into two separate groups; those who underwent cataract surgery in a private center and those operated at a public center. Patients undergoing surgery at a private medical center showed improvement in VA outcomes following treatment (1.80 ± 0.57 and 1.13 ± 0.66, P < 0.01) as opposed to those operated on at our public medical center.

Conclusions

Overall, patients with endophthalmitis following cataract surgery had better visual outcomes and were more likely to show a VA improvement following treatment when compared with endophthalmitis following IVI. Final VA outcomes of patients with endophthalmitis after cataract surgery performed in a private center were better than those operated on and treated in a public medical center.
Literature
1.
Jabbarvand M, Hashemian H, Khodaparast M, Jouhari M, Tabatabaei A, Rezaei S (2016) Endophthalmitis occurring after cataract surgery: outcomes of more than 480 000 cataract surgeries, epidemiologic features, and risk factors. Ophthalmology 123:295–301CrossRef
2.
Miller JJ, Scott IU, Flynn HW Jr et al (2005) Acute-onset endophthalmitis after cataract surgery (2000–2004): incidence, clinical settings, and visual acuity outcomes after treatment. Am J Ophthalmol 139:983–987CrossRef
3.
Prashant G, Aravind R, Savitri S (2017) Endophthalmitis after cataract surgery: epidemiology, risk factors, and evidence on protection. Curr Opin Ophthalmol 28:67–72CrossRef
4.
Reibaldi M (2018) Pooled estimates of incidence of endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents with and without topical antibiotic prophylaxis. Retina 38:1–11CrossRef
5.
Sigford DK, Reddy S, Mollineaux C, Schaal S (2015) Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis. Clin Ophthalmol 9:773–781PubMedPubMedCentral
6.
Fileta JB, Scott IU, Flynn HW (2014) Meta-analysis of infectious endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Ophthalmic Surg Lasers Imaging Retina 45:143–149CrossRef
7.
Yannuzzi NA, Si N, Relhan N, Kuriyan AE, Albini TA, Berrocal AM, Davis JL, Smiddy WE, Townsend J, Miller D et al (2017) Endophthalmitis after clear corneal cataract surgery: outcomes over two decades. Am J Ophthalmol 174:155–159CrossRef
8.
Peyman GA, Lad EM, Moshfegh DM (2009) Intravitreal injection of therapeutic agents. Retina 29:875–912CrossRef
9.
Lalwani GA, Flynn HW Jr, Scott IU, Quinn CM, Berrocal AM, Davis JL, Murray TG, Smiddy WE, Miller D (2008) Acute-onset endophthalmitis after clear corneal cataract surgery (1996–2005). Clinical features, causative organisms, and visual acuity outcomes. Ophthalmology 115:473–476CrossRef
10.
Falavarjani KG, Nguyen QD (2013) Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature. Eye 27:787–794CrossRef
11.
McCannel CA (2011) Meta-analysis of endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents: causative organisms and possible prevention strategies. Retina 31:654–661CrossRef
12.
Schulze-Bonsel K, Feltgen N, Burau H et al (2006) Visual acuities ‘‘hand motion’’ and ‘‘counting fingers’’ can be quantified with the Freiburg visual acuity test. Investig Ophthalmol Vis Sci 47:1236–1240CrossRef
13.
Scott IU, Flynn HW Jr, Acar N et al (2011) Incidence of endophthalmitis after 20-gauge vs 23-gauge vs 25-gauge pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol 249:377–380CrossRef
14.
Taban M, Behrens A, Newcomb RL, Nobe MY, McDonnell PJ (2005) Incidence of acute endophthalmitis following penetrating keratoplasty: a systematic review. Arch Ophthalmol 123(5):605–609CrossRef
15.
Al-Torbak AA, Al-Shahwan S, Al-Jadaan I et al (2005) Endophthalmitis associated with the Ahmed glaucoma valve implant. Br J Ophthalmol 89:454–458CrossRef
16.
Mino de Kaspar H, Shriver EM, Nguyen EV et al (2003) Risk factors for antibiotic-resistant conjunctival bacterial flora in patients undergoing intraocular surgery. Graefes Arch Clin Exp Ophthalmol 241:730–733CrossRef
17.
Kernt M, Kampik A (2010) Endophthalmitis: pathogenesis, clinical presentation, management, and perspectives. Clin Ophthalmol 4:121–135CrossRef
18.
Gower EW, Keay LJ, Stare DE, Arora P, Cassard SD, Behrens A, Tielsch JM, Schein OD (2015) Characteristics of endophthalmitis after cataract surgery in the United States medicare population. Ophthalmology 122:1625–1632CrossRef
19.
Morlet N, Li J, Semmens J, Ng J (2003) The endophthalmitis population study of Western Australia (EPSWA). Br J Ophthalmol 87:574–576CrossRef
20.
Barry P, Seal DV, Gettinby G et al (2006) ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: preliminary report of principal results from a European multicenter study. J Cataract Refract Surg 32:407–410CrossRef
21.
Shah CP, Garg SJ, Vander JF et al (2011) Outcomes and risk factors associated with endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Ophthalmology 118:2028–2034CrossRef
22.
Lemley CA, Han DP (2007) Endophthalmitis: a review of current evaluation and management. Retina 27:662–680CrossRef
23.
Pathengay A, Moreker MR, Puthussery R et al (2011) Clinical and microbiologic review of culture-proven endophthalmitis caused by multidrug-resistant bacteria in patients seen at a tertiary eye care center in southern India. Retina 31:1806–1811CrossRef
24.
Simunovic MP, Rush RB, Hunyor AP, Chang AA (2012) Endophthalmitis following intravitreal injection versus endophthalmitis following cataract surgery: clinical features, causative organisms and post-treatment outcomes. Br J Ophthalmol 96:862–866CrossRef
25.
Endophthalmitis Vitrectomy Study Group (1995) A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Arch Ophthalmol 113:1479–1496CrossRef
26.
Storey P, Dollin M, Pitcher J et al (2014) The role of topical antibiotic prophylaxis to prevent endophthalmitis after intravitreal injection. Ophthalmology 121:283–289CrossRef
27.
Rizzo JL, Chin EK, Rashid S, Park SS (2012) Exogenous endophthalmitis: post-operative versus post-intravitreal injection. Vis Pan Am 11:38–43
28.
Sommer A, Belkin A, Ofir S, Assia E (2017) Profile of patients presenting for cataract surgery in a public hospital: a 15 year perspective. Isr Med Assoc J 19:109–113PubMed
29.
Antcliff RJ, Spalton DJ, Stanford MR et al (2001) Intravitreal triamcinolone for uveitic cystoid macular edema: an optical coherence tomography study. Ophthalmology 108:765–772CrossRef
30.
Greenberg PB, Martidis A, Rogers AH et al (2002) Intravitreal triamcinolone acetonide for macular oedema due to central retinal vein occlusion. Br J Ophthalmol 86:247–248CrossRef
31.
Jonas JB, Sofker A (2001) Intraocular injection of crystalline cortisone as adjunctive treatment of diabetic macular edema. Am J Ophthalmol 132:425–427CrossRef
32.
Sutter FKP, Gillies MC (2003) Pseudo-endophthalmitis after intravitreal injection of triamcinolone. Br J Ophthalmol 87:972–974CrossRef
33.
Nelson ML, Tennant MTS, Sivalingam A, Regillo CD, Belmont JB, Martidis A (2003) Infectious and presumed noninfectious endophthalmitis after intravitreal triamcinolone acetonide injection. Retina 23:686–691CrossRef
34.
Taban M, Singh RP, Chung J, Lowder CY, Perez VL, Kaiser PK (2007) Sterile endophthalmitis after intravitreal triamcinolone: a possible association with uveitis. Am J Ophthalmol 144:50–54CrossRef
35.
Sakamoto T, Enaida H, Kubota T, Nakahara M, Yamakiri K, Yamashita T, Yokoyama M, Hata Y, Murata T, Miyata K et al (2004) Incidence of acute endophthalmitis after triamcinolone-assisted pars plana vitrectomy. Am J Ophthalmol 138:137–138CrossRef
36.
Fong A, Chan C (2017) Presumed sterile endophthalmitis after intravitreal triamcinolone (Kenalog)-more common and less benign than we thought? Asia Pac J Ophthalmol 6:45–49CrossRef
37.
Marticorena J, Romano V, Gómez-Ulla F (2012) Sterile endophthalmitis after intravitreal injections. Mediat Inflamm 2012:92812CrossRef
Metadata
Title
Endophthalmitis after intravitreal injections versus cataract surgery: a 15-year cohort
Authors
Nimrod Dar
Shani Pillar
Asaf Friehmann
Avner Belkin
Shay Ofir
Publication date
01-01-2020
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 1/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-019-01153-1

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