Acute postoperative endophthalmitis after phacoemulsification in a private ophthalmic surgical group.

Archivos de la Sociedad Espanola de Oftalmologia Pub Date : 2024-12-04 DOI:10.1016/j.oftale.2024.07.012

A Llovet-Rausell, F Llovet-Osuna, J Ortega-Usobiaga, J Beltran-Sanz, V Druchkiv

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Abstract

Purpose: To analyze the incidence, causes, risk factors and treatment of acute postoperative endophthalmitis (POE) after phacoemulsification in a private ophthalmological group.

Design: Uncontrolled retrospective observational study of all cases of POE over 22 years.

Material and methods: 369,476 eyes were included after phacoemulsification in 41 surgical centers of the Clínica Baviera-AIER EYE Group from 2002 to 2023. POE cases were reviewed.

Results: The general group was divided into two: group A (2002-2007), with vancomycin in the intracameral irrigation flow (27,705 eyes); Group B (2008-2023), with intracameral cefuroxime (341,771 eyes). 31 cases of POE were found (incidence, 0.0084%); 5 in group A (0.018%) and 26 in group B (0.0076%) (P = .314), with a mean age of 67.3 years (14 men and 17 women). Cultures were positive in 14 cases in Groups A and B. Treatment was based on intravitreal antibiotics and vitrectomy. The mean time to symptom onset was 6.76 days and the mean time to resolution was 120.7 days. 12 eyes achieved corrected distance visual acuity ≥ 20/40.

Conclusions: The incidence of POEwas 0.0084% (0.0181% in group A and 0.0076% in group B). The probability of having POE in group A was 2.37 times greater than in group B (OR: 2.37; 95% CI: 0.71-6.2; P = .079). The only significant risk factor for POE was posterior capsular rupture.

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白内障超声乳化术后急性眼内炎的研究。

目的：分析某专科眼科超声乳化术后急性眼内炎（POE）的发生率、原因、危险因素及治疗。设计：对22年以上所有POE病例进行非对照回顾性观察研究。材料与方法：2002 - 2023年，在Clínica Baviera-AIER眼科集团41个手术中心进行超声乳化术后的369,476只眼。对POE病例进行了审查。结果：普通组分为两组：A组（2002 ~ 2007年），应用万古霉素进行眼内灌流（27,705眼）；B组（2008 - 2023），眼内应用头孢呋辛（341,771眼）。POE 31例（发生率0.0084%）；A组5例（0.018%），B组26例（0.0076%）（p = 0.314），平均年龄67.3岁（男14例，女17例）。A、b组培养阳性14例，采用玻璃体内抗生素和玻璃体切除治疗。平均出现症状时间为6.76 d，平均缓解时间为120.7 d。12眼矫正距离视力≥20/40。结论：POE发生率为0.0084% (A组为0.0181%，B组为0.0076%)，A组发生POE的概率是B组的2.37倍(OR: 2.37；95% ci: 0.71-6.2；p = 0.079)。POE的唯一显著危险因素是后囊膜破裂。

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Archivos de la Sociedad Espanola de Oftalmologia

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