| Title | The incidence of postoperative endophthalmitis after cataract surgery in China: a multicenter investigation of 2006-2011 |
| Authors | Yao, Ke Zhu, Yanan Zhu, Zhihong Wu, Jianjun Liu, Yizhi Lu, Yi Hao, Yansheng Bao, Yongzhen Ye, Jian Huang, Yusen Li, Zhaohui Shentu, Xingchao Yu, Yibo |
| Affiliation | Zhejiang Univ, Ctr Eye, Coll Med, Affiliated Hosp 2, Hangzhou 310009, Zhejiang, Peoples R China. Key Lab Ophthalmol Zhejiang Prov, Hangzhou, Zhejiang, Peoples R China. Zhejiang Univ, Key Lab Cardiovasc Dis Zhejiang Prov, Coll Med, Affiliated Hosp 2, Hangzhou 310009, Zhejiang, Peoples R China. Zhejiang Univ, Coll Sci, Dept Math & Stat, Hangzhou 310009, Zhejiang, Peoples R China. Zhongshan Ophthalm Ctr, Guangzhou, Guangdong, Peoples R China. Fudan Univ, Dept Ophthalmol, Eye & ENT Hosp, Shanghai 200433, Peoples R China. Peking Univ, Dept Ophthalmol, Hosp 3, Beijing 100871, Peoples R China. Peking Univ, Dept Ophthalmol, Peoples Hosp, Beijing 100871, Peoples R China. Third Mil Med Univ, Dept Ophthalmol, Da Ping Hosp, Chongqing, Peoples R China. Shandong Eye Inst, Qingdao, Peoples R China. 301 Mil Hosp, Dept Ophthalmol, Beijing, Peoples R China. |
| Keywords | Epidemiology POSTCATARACT ENDOPHTHALMITIS IRRIGATING SOLUTIONS PHACOEMULSIFICATION CONTAMINATION ANTIBIOTICS VANCOMYCIN OUTCOMES PROPHYLAXIS POPULATION VITRECTOMY |
| Issue Date | 2013 |
| Publisher | british journal of ophthalmology |
| Citation | BRITISH JOURNAL OF OPHTHALMOLOGY.2013,97,(10),1312-1317. |
| Abstract | Aims To estimate the cumulative incidence of postoperative endophthalmitis, identify risk factors and determine clinical outcomes in China. Methods Medical records were reviewed for all patients with acute-onset endophthalmitis after cataract surgery from January 2006 to December 2011 at eight eye centres of tertiary care hospitals in China. Results Sixty-six cases of presumed endophthalmitis occurred after 201757 cataract surgeries, yielding a cumulative incidence of 0.033% (95% CI 0.025 to 0.041). Logistic regression analysis revealed that the risk of endophthalmitis increased with intraoperative communication with vitreous (multivariate OR 9.96; 95% CI 4.54 to 21.84; p<0.001). After a median follow-up of 153days, best-corrected visual acuity in the affected eye was more than 20/70 in 29/65 (44.6%) patients, and more than 20/40 in 20/65 (30.8%). A predictor of good visual acuity was baseline acuity of counting fingers or better (OR 6.25; 95% CI 2.13 to 18.33). Of 64 cases, 25 (39.1%) were culture positive. Coagulase-negative Staphylococcus and Pseudomonas species were the most common organisms isolated, accounting for 72.0% of the culture-positive cases (18/25). Two eye centres that used a combination of a high concentration vancomycin (1mg/0.1mL intracameral vancomycin injection or 100 mu g/mL vancomycin in irrigating solution) and tobramycin as infection prophylaxis achieved a lower incidence of endophthalmitis than other centres (p<0.001). Conclusions The incidence of acute postoperative endophthalmitis after cataract surgery in tertiary care hospitals of China was 0.033%. Intraoperative communication with vitreous was a major risk factor for developing endophthalmitis. Prophylactic use of a high-concentration vancomycin and tobramycin may play a positive role in the prevention of postoperative endophthalmitis after cataract surgery. |
| URI | http://hdl.handle.net/20.500.11897/391065 |
| ISSN | 0007-1161 |
| DOI | 10.1136/bjophthalmol-2013-303282 |
| Indexed | SCI(E) |
| Appears in Collections: | 第三医院 人民医院 |
