عنوان انگلیسی مقاله:
Endophthalmitis after Cataract Surgery in the United States
ترجمه فارسی عنوان مقاله:
اندوفتالمیتیس پس از جراحی آب مروارید در ایالات متحده
Sciencedirect - Elsevier - Ophthalmology, 127 (2020) 151-158: doi:10:1016/j:ophtha:2019:08:026
Suzann Pershing, MD, MS,1,2 Flora Lum, MD,3 Stephen Hsu, MS,3 Scott Kelly, PhD,3 Michael F. Chiang, MD,4 William L. Rich III, MD,3 David W. Parke II, MD3
Purpose: To determine recent incidence and visual outcomes for acute-onset endophthalmitis after cataract
surgery performed in the United States.
Design: Retrospective cohort study.
Participants: United States cataract surgery patients, 2013-2017 (5 401 686 patients).
Methods: Cases of acute-onset postoperative endophthalmitis occurring within 30 days after cataract
surgery were identified using diagnosis codes in the American Academy of Ophthalmology IRIS (Intelligent
Research in Sight) Registry database, drawn from electronic health records in ophthalmology practices
across the nation. Annual and aggregate 5-year incidences were determined for all cataract surgeries
and specifically for standalone procedures versus those combined with other ophthalmic surgeries.
Patient characteristics were compared. Mean and median visual acuity was determined at 1 month preoperative
as well as 1 week, 1 month, and 3 months postoperative among patients with and without
Main Outcome Measures: Incidence of acute-onset postoperative endophthalmitis after cataract
Results: A total of 8 542 838 eyes underwent cataract surgery, 3629 of which developed acute-onset
endophthalmitis (0.04%; 95% confidence interval, 0.04%e0.04%). Endophthalmitis incidence was highest
among patients aged 0 to 17 years (0.37% over 5 years), followed by patients aged 18 to 44 years (0.18% over 5
years; P < 0.0001). Endophthalmitis occurred 4 times more often after combined cases (cataract with other
ophthalmic procedures) than after standalone cataract surgeries (0.20% vs. 0.04% of cases), and occurred in
0.35% of patients receiving anterior vitrectomy. Mean 3-month postoperative visual acuity was 20/100 (median,
20/50) among endophthalmitis patients, versus a mean of approximately 20/40 (median, 20/30) among patients
without endophthalmitis. However, 4% of endophthalmitis patients still achieved 20/20 or better visual acuity, and
44% achieved 20/40 or better visual acuity at 3 months.
Conclusions: Acute-onset endophthalmitis occurred in 0.04% of 8 542 838 cataract surgeries performed in
the United States between 2013 and 2017. Risk factors may include younger age, cataract surgery combined with
other ophthalmic surgeries, and anterior vitrectomy. Visual acuity outcomes vary; however, patients can recover
excellent vision after surgery. Big data from clinical registries like the IRIS Registry has great potential for
evaluating rare conditions such as endophthalmitis, including developing benchmarks, longer-term time trend
investigation, and comprehensive analysis of risk factors and prophylaxis. Ophthalmology 2020;127:151-
158 Published by Elsevier on behalf of the American Academy of Ophthalmology