Kelly Weston1, Rory Nicholson1, Catey Bunce2, Yit Fung Yang1. 1. Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK. 2. NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK London School of Hygiene & Tropical Medicine, London, UK.
Abstract
BACKGROUND/AIMS: Postoperative endophthalmitis (POE) is a rare but potentially devastating complication of modern cataract surgery. We examine whether the use of injectable intraocular lenses (IOLs) is associated with a lower rate of POE after cataract surgery compared with forceps-inserted foldable IOLs. METHODS: A single-centre retrospective cohort study of 25 410 cataract operations was performed over an 8-year period when standard practice in cataract surgery changed from the use of forceps-inserted foldable IOLs to injectable IOLs. Cases of POE were identified and the rates compared between the two groups. RESULTS: Twelve cases of POE were identified in the study period. The rate of POE was significantly lower in the injectable IOL group compared with the forceps-inserted foldable IOL group (0.008% vs 0.081%, p=0.008). This difference remained significant when controlling for posterior capsular rupture and lens material. CONCLUSIONS: This study, the largest of its kind to date, supports the use of injectable IOLs over forceps-inserted foldable IOLs as a significant measure in reducing the risk of POE. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND/AIMS: Postoperative endophthalmitis (POE) is a rare but potentially devastating complication of modern cataract surgery. We examine whether the use of injectable intraocular lenses (IOLs) is associated with a lower rate of POE after cataract surgery compared with forceps-inserted foldable IOLs. METHODS: A single-centre retrospective cohort study of 25 410 cataract operations was performed over an 8-year period when standard practice in cataract surgery changed from the use of forceps-inserted foldable IOLs to injectable IOLs. Cases of POE were identified and the rates compared between the two groups. RESULTS: Twelve cases of POE were identified in the study period. The rate of POE was significantly lower in the injectable IOL group compared with the forceps-inserted foldable IOL group (0.008% vs 0.081%, p=0.008). This difference remained significant when controlling for posterior capsular rupture and lens material. CONCLUSIONS: This study, the largest of its kind to date, supports the use of injectable IOLs over forceps-inserted foldable IOLs as a significant measure in reducing the risk of POE. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
Infection; Lens and zonules; Microbiology; Prosthesis; Treatment Surgery
Authors: Daniel Black; Dean Corbett; Timothy V Roberts; Brendan Cronin; Pamela J Smith; D Priya Janakiraman; Beth E Jackson Journal: Clin Ophthalmol Date: 2020-08-12