Postoperative endophthalmitis following cataract surgery: Incidence and visual outcomes at ECWA Eye Hospital, Kano, Nigeria

Abstract

Purpose

To evaluate the incidence and visual outcomes of postoperative endophthalmitis following cataract surgery at ECWA Eye Hospital, Kano.

Study design

Retrospective chart review.

Methods

This retrospective study reviewed 9,782 cataract surgeries performed between January 2021 and December 2023, encompassing extracapsular cataract extraction, small-incision cataract surgery, and phacoemulsification. Data collected included patient demographics, surgical details, time to onset of endophthalmitis, visual acuity outcomes, and microbiological findings. Descriptive statistics were used to summarize the findings, and incidence rates were calculated with confidence intervals using the Wilson Score Interval. Chi-Square tests were used to assess associations between surgical techniques and visual outcomes, and logistic regression to identify predictors of improved visual acuity. A significance threshold of p < 0.05 was applied, ensuring rigorous evaluation of the relationships between surgical techniques, patient characteristics, and visual recovery.

Results

The overall incidence of postoperative endophthalmitis was 0.17% (17/9,782; 95% CI: 0.10%–0.26%). The highest incidence was recorded in 2022 (0.22%, 8/3,625). Visual acuity improved in 52.9% of patients post-treatment, while 23.5% showed no change, and 23.5% experienced worsened outcomes. Earlier onset of infection (OR: 0.72, p = 0.01) and surgeries performed by experienced full-time staff (OR: 2.50, p = 0.03) significantly predicted better outcomes. No statistically significant association was observed between procedure type and visual outcomes (p = 0.12). No microbial growth was detected in vitreous cultures, likely due to prior antibiotic use.

Conclusion

The incidence of postoperative endophthalmitis at ECWA Eye Hospital aligns with global benchmarks, highlighting the critical importance of adhering to preventive strategies, surgical precautions, and robust training programs. Visual outcomes are significantly influenced by early diagnosis and surgeon expertise.