Acute-onset endophthalmitis after cataract surgery (2000-2004): incidence, clinical settings, and visual acuity outcomes after treatment

Am J Ophthalmol. 2005 Jun;139(6):983-7. doi: 10.1016/j.ajo.2005.01.025.


Purpose: To report the incidence, clinical settings, and visual acuity outcomes of acute-onset endophthalmitis after cataract surgery.

Design: Retrospective, observational case series.

Methods: Annual cataract surgery statistics were determined by review of electronic surgical records. The clinical and microbiologic records were reviewed of all patients with clinically diagnosed endophthalmitis within 6 weeks after cataract surgery at a single university-affiliated hospital between January 2000 and November 2004. main outcome measures: Operative technique, intraoperative complications, and visual acuity.

Results: The incidence of acute-onset endophthalmitis after cataract surgery was 0.04% (7/15,920) for cataract surgeries of all methods, 0.05% (6/11,462) for cataract surgery by clear cornea phacoemulsification, and 0.02% (1/4,458) for cataract surgery by methods other than clear cornea phacoemulsification (P = .681, Fisher's exact test). Six of seven (86%) cases occurred in the right eye, and all cases were performed by right-handed surgeons through temporal incisions. Five of seven (71%) patients had relative immune compromise. Four of seven (57%) patients had an intraoperative complication: vitreous loss in three patients and iris prolapse in one patient. Two patients had topical placement of lidocaine 2% gel before povidone-iodine preparation. The visual acuity at final follow up was 20/25 or better in four patients and count fingers or worse in three patients.

Conclusions: The incidence of acute-onset endophthalmitis after temporal clear cornea incision phacoemulsification is low (0.05%). Potential risk factors for endophthalmitis may include intraoperative complications, relative immune compromise, application of lidocaine 2% gel before povidone-iodine preparation, and inferior incision location.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Bacteria / isolation & purification
  • Drug Resistance, Bacterial
  • Endophthalmitis / epidemiology*
  • Endophthalmitis / microbiology
  • Endophthalmitis / therapy
  • Florida / epidemiology
  • Humans
  • Incidence
  • Intraoperative Complications
  • Microbial Sensitivity Tests
  • Middle Aged
  • Phacoemulsification / statistics & numerical data*
  • Postoperative Complications*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Visual Acuity / physiology*