The patient profile in acute endophthalmitis referral has evolved over a decade

New findings suggest that the profile of patients referred for acute endophthalmitis has evolved over the past decade.

The data show a decrease in the raw number of cases of endophthalmitis after cataract surgery as opposed to an increase in the number of patients who experienced endophthalmitis after intravitreal injections.

“The overall incidence of acute endophthalmitis was 1 in 1920 procedures,” wrote study author Catherine Creuzot-Garcher, MD, PhD, Department of Ophthalmology, University Hospital, Dijon, France.

Alongside his colleagues, Creuzot-Garcher endeavored to describe longitudinally, on a national scale, the causes of acute postoperative endophthalmitis. The cohort study took place from 2009 to 2018 in France.

The participants included were people diagnosed with acute endophthalmitis after intraocular procedures. Investigators collected patient information from the French medico-administrative database.

They identified cases of endophthalmitis and intraocular procedures based on billing codes in all French hospitals and private practices. The primary outcome of the study was the incidence of acute endophthalmitis within 42 days postoperatively.

From January 2009 to October 2018, a total of 7,522 cases of acute endophthalmitis occurred after 14,438,854 intraocular procedures. The majority of cases occurred after isolated cataract surgery (4,808 cases for 7,316,077 procedures; 63.92%), followed by intravitreal injections (1,296 cases for 5,455,631 intravitreal injections; 17.23% ).

Next come vitreoretinal surgery (698 for 442,263 procedures; 9.28%), anterior segment surgery (245 cases; 3.26%), combined cataract and vitreoretinal surgery (698 for 442,263 procedures; 9.28% ), surgery of the anterior segment (245 cases; 3.25%), combined cataract and vitreoretinal surgery (191 cases, 2.54%), corneal surgery (142 cases, 1.89%) and surgery of the glaucoma (80 cases, 1.06%).

Investigators found the overall incidence rate of acute endophthalmitis to be 0.0521% (95% confidence interval [CI], 0.0520 – 0.0522). The surgery with the highest incidence of endophthalmitis was scleral and globe surgery, with an incidence of 0.1827% (95% CI, 0.1757, 0.1898).

The second highest incidence was vitreoretinal surgery combined with cataract surgery, with an incidence of 0.1685% (95% CI, 0.1663, 0.1706). The data show that the incidence of endophthalmitis after intravitreal injection was stable throughout the stable period, and those who received intravitreal injections were oldest at age 75.4 years (standard deviation, 12. 0 years; P <.001>

Additionally, the onset of endophthalmitis after intravitreal procedures, including vitreoretinal injection or surgery, was earlier than after other procedures (P <.001>

The study, “Epidemiology of Acute Endophthalmitis after Intraocular Procedures: A National Database Study,” was published in Ophthalmology.

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