Incidence and Risk Factors of New Onset Endotheliitis After Cataract Surgery

Invest Ophthalmol Vis Sci. 2018 Oct 1;59(12):5210-5216. doi: 10.1167/iovs.18-24750.

Abstract

Purpose: The purpose of this study was to report the characteristics of new-onset endotheliitis after cataract surgery and to identify contributing risk factors.

Methods: In this single-center study, we retrospectively reviewed the clinical records of all patients who underwent uneventful cataract surgery in the Eye Hospital of Wenzhou Medical University between January 2015 and December 2016. Postoperative endotheliitis cases were identified by screening of keywords and individually verified by a cornea specialist. Endotheliitis rates and 95% confidence intervals (CI) were calculated. Cox proportional hazard regression analysis was used to investigate the association between endotheliitis and associated factors.

Results: A total of 20,743 cataract surgeries were performed. Fifty-nine eyes developed endotheliitis after cataract surgery, with an incidence of 0.28%. The mean interval between surgery and first record of endotheliitis was 24.51 ± 9.50 days (range, 5 to 45 days); 45 (76.27%) cases of endotheliitis developed within 30 days. The multiadjusted hazard ratio (HR) associated with increased risk of endotheliitis was 16.1 (95% CI, 3.9 to 66.9; P < 0.001) for patients 76 years of age or older and 10.2 (95% CI, 2.4 to 43.2; P = 0.002) for those 66 to 75 years of age compared with those 65 years of age or younger. Endotheliitis was also associated with history of diabetes mellitus (HR, 1.9; 95% CI, 1.1 to 3.2; P = 0.026).

Conclusions: This study found the incidence of endotheliitis after cataract surgery to be 0.28%. Diabetes mellitus and old age are major risk factors for developing endotheliitis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cataract Extraction / statistics & numerical data*
  • China / epidemiology
  • Endothelium, Corneal / pathology*
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Incidence
  • Keratitis / diagnosis
  • Keratitis / drug therapy
  • Keratitis / epidemiology*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prednisolone / therapeutic use
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Time Factors

Substances

  • Glucocorticoids
  • Prednisolone