Increased incidence of endophthalmitis after vitrectomy relative to face mask wearing during COVID-19 pandemic

Br J Ophthalmol. 2023 Oct;107(10):1472-1477. doi: 10.1136/bjophthalmol-2022-321357. Epub 2022 Jun 21.

Abstract

Background/aims: To determine the incidence and causative pathogens of endophthalmitis after vitrectomy during strict face mask wearing in the COVID-19 period.

Methods: This was a retrospective multicentre study including 31 ophthalmological institutions of the Japanese Retina and Vitreous Society or Japan-Clinical Retina Study group. Patients who had undergone vitrectomy during 2019, the pre-COVID-19 period, and from July 2020 to June 2021, the COVID-mask period, were studied. The results of cataract surgery were used as a control. The total number of vitrectomies and the total number of postoperative endophthalmitis were determined. Then, the differences in the incidence of postoperative endophthalmitis between the pre-COVID-19 period and the COVID-mask period, and the type of pathogens causing the endophthalmitis were studied.

Results: The incidence of postvitrectomy endophthalmitis was significantly lower in the pre-COVID-19 period with 16 568 surgeries and 18 endophthalmitis cases (0.11%) than in the COVID-mask period of 14 929 surgeries and 31 endophthalmitis cases (0.21%; p=0.031, OR=1.913, 95% CI 1.078 to 3.394). In the pre-COVID-19 period, 4 of the 18 eyes were culture positive, and all were of the Staphylococcus family. In the COVID-mask period, 9 of the 31 eyes were culture positive, and 4 cases were related to oral commensals including Streptococcus spp, which are reportedly very rare in endophthalmitis after vitrectomy.

Conclusions: It is necessary for physicians to be aware of the higher incidence of postvitrectomy endophthalmitis during the COVID-mask period, and to treat their patients appropriately.

Keywords: Covid-19; Infection; Retina.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • Endophthalmitis* / drug therapy
  • Endophthalmitis* / epidemiology
  • Endophthalmitis* / etiology
  • Eye Infections, Bacterial* / drug therapy
  • Eye Infections, Bacterial* / epidemiology
  • Eye Infections, Bacterial* / etiology
  • Humans
  • Incidence
  • Masks / adverse effects
  • Pandemics
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Vitrectomy / adverse effects
  • Vitrectomy / methods
  • Vitreous Body

Substances

  • Anti-Bacterial Agents