Tetsuro Oshika1, Yuichi Ohashi2. 1. From the Departments of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki (Oshika), and Graduate School of Medicine, Ehime University, Ehime (Ohashi), Japan. Electronic address: oshika@eye.ac. 2. From the Departments of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki (Oshika), and Graduate School of Medicine, Ehime University, Ehime (Ohashi), Japan.
Abstract
PURPOSE: To analyze the outcomes of cataract surgery with emphasis on the relationship between surgery-related factors and the incidence of postoperative infectious endophthalmitis. SETTING: Ninety-three surgical sites in Japan. DESIGN: Prospective case series. METHODS: Eyes that were scheduled to have cataract surgery from January 20 to September 30, 2014, were included. Phacoemulsification and implantation of a single-piece hydrophobic acrylic foldable intraocular lens (IOL) were performed. Patients were followed for 2 months. RESULTS: Of the 9720 eyes enrolled, 9100 (93.6%) completed a 2-month follow-up. Three cases (0.033%) developed infectious endophthalmitis (95% confidence interval [CI], 0.000-0.070). The incidence of endophthalmitis was significantly associated with the removal method of ophthalmic viscosurgical devices (OVDs) after IOL implantation. The incidences of endophthalmitis in cases with and without the behind-the-lens technique were 0% (0/6147; 95% CI, 0%) and 0.084% (3/3570; 95% CI, 0.000-0.179), respectively, with a significant difference between them (P = .050, Fisher exact test). The incidence of infectious endophthalmitis did not correlate with any other patient-related and surgery-related factors. CONCLUSION: The behind-the-lens technique to wash and clear the capsular bag for OVD removal significantly reduced the incidence of infectious endophthalmitis.
PURPOSE: To analyze the outcomes of cataract surgery with emphasis on the relationship between surgery-related factors and the incidence of postoperative infectious endophthalmitis. SETTING: Ninety-three surgical sites in Japan. DESIGN: Prospective case series. METHODS: Eyes that were scheduled to have cataract surgery from January 20 to September 30, 2014, were included. Phacoemulsification and implantation of a single-piece hydrophobic acrylic foldable intraocular lens (IOL) were performed. Patients were followed for 2 months. RESULTS: Of the 9720 eyes enrolled, 9100 (93.6%) completed a 2-month follow-up. Three cases (0.033%) developed infectious endophthalmitis (95% confidence interval [CI], 0.000-0.070). The incidence of endophthalmitis was significantly associated with the removal method of ophthalmic viscosurgical devices (OVDs) after IOL implantation. The incidences of endophthalmitis in cases with and without the behind-the-lens technique were 0% (0/6147; 95% CI, 0%) and 0.084% (3/3570; 95% CI, 0.000-0.179), respectively, with a significant difference between them (P = .050, Fisher exact test). The incidence of infectious endophthalmitis did not correlate with any other patient-related and surgery-related factors. CONCLUSION: The behind-the-lens technique to wash and clear the capsular bag for OVD removal significantly reduced the incidence of infectious endophthalmitis.