Endophthalmitis after intravitreal injections versus cataract surgery: a 15-year cohort

Int Ophthalmol. 2020 Jan;40(1):73-79. doi: 10.1007/s10792-019-01153-1. Epub 2019 Aug 14.

Abstract

Purpose: To compare the clinical features, visual outcomes and causative organisms between endophthalmitis secondary to cataract surgery or to intravitreal injections (IVI).

Setting: Meir Medical Center, Kfar Saba, Israel.

Design: Retrospective, non-randomized comparative chart review.

Methods: Medical records of patients with proven or suspected endophthalmitis admitted to the Ophthalmology Department at Meir Medical Center 2/2002-2/2017 were reviewed. Clinical characteristics including presenting and final visual acuity (VA) outcomes, causative organisms and time to admission were assessed.

Results: Among 84 patients in our study, 35 had preceding cataract surgery and 12 had preceding IVI. The post-cataract group showed a significant improvement in VA following treatment with a presenting and final VA (logMar ± SD) of (1.80 ± 0.54 and 1.39 ± 0.65, P < 0.01) as opposed to the post-IVI group (1.72 ± 0.26 and 1.81 ± 0.32, P = 0.692), while most patients in the cataract group exhibited some degree of VA recovery (70.96%). Patients undergoing cataract surgery were divided into two separate groups; those who underwent cataract surgery in a private center and those operated at a public center. Patients undergoing surgery at a private medical center showed improvement in VA outcomes following treatment (1.80 ± 0.57 and 1.13 ± 0.66, P < 0.01) as opposed to those operated on at our public medical center.

Conclusions: Overall, patients with endophthalmitis following cataract surgery had better visual outcomes and were more likely to show a VA improvement following treatment when compared with endophthalmitis following IVI. Final VA outcomes of patients with endophthalmitis after cataract surgery performed in a private center were better than those operated on and treated in a public medical center.

Keywords: Cataract surgery; Endophthalmitis; Intravitreal injections.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects
  • Cataract Extraction / adverse effects*
  • Endophthalmitis / diagnosis
  • Endophthalmitis / etiology*
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / etiology*
  • Female
  • Follow-Up Studies
  • Forecasting*
  • Humans
  • Intravitreal Injections / adverse effects
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / etiology*
  • Vancomycin / administration & dosage
  • Vancomycin / adverse effects*
  • Visual Acuity*

Substances

  • Anti-Bacterial Agents
  • Vancomycin