Acute postoperative endophthalmitis after resurgery following primary cataract surgery: 9 years experience from a tertiary eyecare center.

Abstract

PURPOSE\nTo report the incidence, risk factors, and visual outcomes of acute postoperative endophthalmitis in patients undergoing resurgery after cataract surgery.\n\n\nSETTING\nTertiary eye hospital in southern India.\n\n\nDESIGN\nRetrospective, clinical registry.\n\n\nMETHODS\nMedical records of patients were retrospectively reviewed from January 2010 to December 2018. Incidence, risk factors, causative organisms, management, and outcomes were studied. Patients who underwent resurgery within 6 weeks of primary cataract surgery and developed endophthalmitis within 6 weeks of resurgery were included.\n\n\nRESULTS\nA total of 5705 patients (0.64%) underwent resurgery. Of 5705 resurgeries, 11 patients (0.19%) developed postoperative endophthalmitis. The incidence of endophthalmitis was higher in the eyes having a breach in the posterior capsule than the eyes with no breach in the posterior capsule (10/1277 [0.78%] vs 1/4428 [0.02%]). Among the 11 patients, secondary intraocular lens (IOL) implantation was the most common indication for resurgery (9/11 [82%]) after which endophthalmitis occurred. Three (27.3%) of the 11 patients were culture-positive. Nine (82%) of 11 patients were managed with a vitreous tap along with intravitreal antibiotics and steroid injections. After treatment, 80% of the patients achieved a visual acuity of 6/18 or greater (logMAR 0.5, P value < .05). None of the eyes developed phthisis bulbi.\n\n\nCONCLUSIONS\nEyes having a breach in the posterior capsule requiring vitrectomy and taken for resurgery as secondary IOL implantation were having an increased risk for endophthalmitis. The posttreatment visual outcomes were favorable.