Top

Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

01-08-2006 | Clinical Investigation

Nosocomial postoperative endophthalmitis: a 14-year review

Authors: Pei-Chang Wu, Hsi-Kung Kuo, Mien Li, Ing-Chou Lai, Po-Chiung Fang, Sue-Ann Lin, Shyi-Jang Shin, Yung-Jen Chen, Mei-Ching Teng

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 8/2006

Abstract

Background

The objective of this study was to evaluate the incidence, predisposing surgery, management and final visual outcome of postoperative endophthalmitis over a 14-year period at one institute.

Methods

This retrospective study reviewed all intraocular operations performed between 1 January 1991 and 31 August 2004 at Chang Gung Memorial Hospital, Kaohsiung Medical Center, to determine the incidence of nosocomial postoperative endophthalmitis and the characteristics of patients who developed this condition.

Results

The overall incidence of postoperative endophthalmitis after intraocular surgery was 0.19% (56 out of 30,219). Postoperative endophthalmitis developed in 56 eyes in 56 patients during the study period. The condition developed after cataract surgery in 46 eyes, after penetrating keratoplasty in 6 eyes, after filtering surgery in 2 eyes, after secondary intraocular lens implant in 1 eye, and after vitrectomy in 1 eye. Postoperative endophthalmitis was culture-positive in 31 cases (55%). The most frequent organism isolated was coagulase-negative Staphylococcus. Factors associated with better visual acuity outcomes included low virulence of isolated pathogen, initial visual acuity of counting fingers or better, and history of cataract surgery compared with other intraocular surgery.

Conclusion

The overall incidence of endophthalmitis after intraocular surgery was 0.19%. The results of this 14-year review from a local medical center may serve as a source of comparison for other centers and future studies.

Aaberg TM Jr, Flynn HW Jr, Schiffman J, Newton J (1998) Nosocomial acute-onset postoperative endophthalmitis survey. A 10-year review of incidence and outcomes. Ophthalmology 105:1004–1010PubMedCrossRef

Antonios SR, Cameron JA, Badr IA et al (1991) Contamination of donor cornea: postpenetrating keratoplasty endophthalmitis. Cornea 10:217–220PubMedCrossRef

Cosar CB, Cohen EJ, Rapuano CJ, Laibson PR (2001) Clear corneal wound infection after phacoemulsification. Arch Ophthalmol 119:1755–1759PubMed

Eifrig CW, Flynn HW Jr, Scott IU, Newton J (2002) Acute-onset postoperative endophthalmitis: review of incidence and visual outcomes (1995–2001). Ophthalmic Surg Lasers 33:373–378PubMed

Endophthalmitis Vitrectomy Study Group (1995) Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Arch Ophthalmol 113:1479–1496

Fox GM, Joondeph BC, Flynn HW Jr et al (1991) Delayed-onset pseudophakic endophthalmitis. Am J Ophthalmol 111:163–173PubMed

Garg P, Mahesh S, Bansal AK et al (2003) Fungal infection of sutureless self-sealing incision for cataract surgery. Ophthalmology 110:2173–2177PubMedCrossRef

Hughes DS, Hill RJ (1994) Infectious endophthalmitis after cataract surgery. Br J Ophthalmol 78:227–232PubMedCrossRef

Javitt JC, Vitale S, Canner JK et al (1991). National outcomes of cataract extraction. Endophthalmitis following inpatient surgery. Arch Ophthalmol 109:1085–1089PubMed

10.

Kanellopoulos AJ, Dreyer EB (1996) Postoperative infection following current cataract extraction surgery. Int Ophthalmol Clin 36:97–107PubMedCrossRef

11.

Kattan HM, Flynn HW Jr, Pflugfelder SC et al (1991) Nosocomial endophthalmitis survey. Current incidence of infection after intraocular surgery. Ophthalmology 98:227–238PubMed

12.

Koc F, Sen E, Demirbay P et al (2002) Factors influencing treatment results in pseudophakic endophthalmitis. Eur J Ophthalmol 12:34–39PubMed

13.

Li J, Morlet N, Ng JQ et al (2004) Significant nonsurgical risk factors for endophthalmitis after cataract surgery: EPSWA Fourth Report. Invest Ophthalmol Vis Sci 45:1321–1328PubMedCrossRef

14.

Miller KM, Glasgow BJ (1993) Bacterial endophthalmitis following sutureless cataract surgery. Arch Ophthalmol 111:377–379PubMed

15.

Mino de Kaspar H, Grasbon T, Kampik A (2000) Automated surgical equipment requires routine disinfection of vacuum control manifold to prevent postoperative endophthalmitis. Ophthalmology 107:685–690PubMedCrossRef

16.

Mistlberger A, Ruckhofer J, Raithel E et al (1997) Anterior chamber contamination during cataract surgery with intraocular lens implantation. J Cataract Refract Surg 23:1064–1069PubMed

17.

Montan P, Lundstrom M, Stenevi U, Thorburn W (2002) Endophthalmitis following cataract surgery in Sweden. The 1998 national prospective survey. Acta Ophthalmol Scand 80:258–261PubMedCrossRef

18.

Olson RJ (2004) Reducing the risk of postoperative endophthalmitis. Surv Ophthalmol 49 [Suppl 2]:S55–S61PubMedCrossRef

19.

Ormerod LD, Puklin JE, McHenry JG, McDermott ML (1993) Scleral flap necrosis and infectious endophthalmitis after cataract surgery with a scleral tunnel incision. Ophthalmology 100:159–163PubMed

20.

Ormerod LD, Becker LE, Cruise RJ et al (1993) Endophthalmitis caused by the coagulase-negative staphylococci. II. Factors influencing presentation after cataract surgery. Ophthalmology 100:724–729PubMed

21.

Phillips WB Jr, Tasman WS (1994) Postoperative endophthalmitis in association with diabetes mellitus. Ophthalmology 101:508–518PubMed

22.

Samad A, Solomon LD, Miller MA, Mendelson J (1995) Anterior chamber contamination after uncomplicated phacoemulsification and intraocular lens implantation. Am J Ophthalmol 120:143–150PubMed

23.

Sandvig KU, Dannevig L (2003) Postoperative endophthalmitis: establishment and results of a national registry. J Cataract Refract Surg 29:1273–1280PubMedCrossRef

24.

Scott IU, Schein OD, West S et al (1994) Functional status and quality of life measurement among ophthalmic patients. Arch Ophthalmol 112:329–335PubMed

25.

Shrader SK, Band JD, Lauter CB, Murphy P (1990) The clinical spectrum of endophthalmitis: incidence, predisposing factors, and features influencing outcome. J Infect Dis 162:115–120PubMed

26.

Somani S, Grinbaum A, Slomovic AR (1997) Postoperative endophthalmitis: incidence, predisposing surgery, clinical course and outcome. Can J Ophthalmol 32:303–310PubMed

27.

Speaker MG, Milch FA, Shah MK et al (1991) Role of external bacterial flora in the pathogenesis of acute postoperative endophthalmitis. Ophthalmology 98:639–649; discussion 50PubMed

28.

Stonecipher KG, Parmley VC, Jensen H, Rowsey JJ (1991) Infectious endophthalmitis following sutureless cataract surgery. Arch Ophthalmol 109:1562–1563PubMed

29.

Sunaric-Megevand G, Pournaras CJ (1997) Current approach to postoperative endophthalmitis. Br J Ophthalmol 81:1006–1015PubMedCrossRef

30.

Verbraeken HE (1994) Endophthalmitis after lens extraction. Doc Ophthalmol 87:153–158PubMedCrossRef

31.

Wilson FM Jr (1987) Causes and prevention of endophthalmitis. Int Ophthalmol Clin 27:67–73PubMedCrossRef

32.

Wong TY, Chee SP (2004) The epidemiology of acute endophthalmitis after cataract surgery in an Asian population. Ophthalmology 111:699–705PubMedCrossRef

Title: Nosocomial postoperative endophthalmitis: a 14-year review
Authors: Pei-Chang Wu
Hsi-Kung Kuo
Mien Li
Ing-Chou Lai
Po-Chiung Fang
Sue-Ann Lin
Shyi-Jang Shin
Yung-Jen Chen
Mei-Ching Teng
Publication date: 01-08-2006
Publisher: Springer-Verlag
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 8/2006
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-005-0170-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Nosocomial postoperative endophthalmitis: a 14-year review

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2006

Electrophysiology of vision—clinical testing and applications (Byron L. Lam) Taylor & Francis, Boca Raton, London, New York, Singapore, 2005, 514 pp with illustrations, ISBN 0-8247-4068-8

In vivo redirection of retinal blood flow into borosilicate micro-cannulas in rabbits

Paraoxonase 1 gene polymorphisms influence clinical features of open-angle glaucoma

Influence of photodynamic therapy for age related macular degeneration upon subjective vision related quality of life

Asymmetric visual field loss and retrobulbar haemodynamics in primary open-angle glaucoma

Effect of photodynamic therapy on the function of the outer blood-retinal barrier in an in vitro model