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Objective: To determine the incidence of acute-onset postcataract endophthalmitis, identify risk factors, and determine clinical outcomes in a tertiary eye care center in South India. Design: Retrospective, interventional, observational case series. Participants: All patients who underwent cataract extraction from January 2002 to December 2003 at Aravind Eye Hospital, Madurai. Methods: The reco rds of patients with acute endophthalmitis after cataract surgery were reviewed. Main Outcome Measures: Acute-onset postcataract endophthalmitis, incidence rat es, risk factors, organisms cultured, and visual acuity outcomes after treatment . Results: During the study period, 36072 cataract surgeries were performed; the se included 22294 cases of phacoemulsification and 9503 cases of ex tracapsular cataract extraction. A total of 19 eyes developed acute endophthal mitis after cataract surgery (average 2-year incidence, 0.05%). Ten cases were culture positive (average 2-year incidence, 0.03%). In multivariate analysis, increased risk of endophthalmitis was associated with intraoperative complicati ons, such as posterior capsular rent and vitreous loss (relative risk RR, 6.57 ; 95%confidence interval CI, 1.5-28.5; P=0.05) for all endophthalmitis cases , age >60 years for culture positive endophthalmitis cases (RR, 6; 95%CI, 0.7-47.8; P=0.04), and an extracapsular cataract extraction technique for culture-positive endophthalmitis cases (RR, 4.9; 95%CI, 1.2-19.3; P=0.001). After follow-up of 37 days, 5 (29.41%) of the 17 patients achieved a best-corrected visu al acuity (BCVA) of 20/40, and the remaining 7 (32.3%) had a BCVA better than 2 0/200. Of the culture-positive cases, Nocardia species was the most common orga nism isolated, accounting for more than half of these cases (6/10 60%). Conclusions: This study found the incidence of acute postoperative endophthalmitis after cataract surgery to be 0.05%. Extracapsular cataract extraction technique and the occurrence of intraoperative complications are major risk factors for developing endophthalmitis. Visual outcome after endophthalmitis was generally poor. Nocardia is a lesser-known but virulent organism causing endophthalmitis, the management of which still poses a therapeutic dilemma.
Objective: To determine the incidence of acute-onset postcataract endophthalmitis, identify risk factors, and determine clinical outcomes in a tertiary eye care center in South India. Design: Retrospective, interventional, observational case series. Participants: All patients who underwent cataract extraction from January 2002 to December 2003 at Aravind Eye Hospital, Madurai. Methods: The reco rds of patients with acute endophthalmitis after cataract surgery were reviewed. Main Outcome Measures: Acute-onset postcataract endophthalmitis, incidence rat es, risk factors, organisms cultured, and visual acuity outcomes after treatment. Results: During the study period, 36072 cataract surgeries were performed; the se included 22294 cases of phacoemulsification and 9503 cases of ex tracapsular cataract extraction. A total of 19 eyes developed acute endophthal mitis after cataract surgery (average 2- year incidence, 0.05%). Ten cases were culture positive (average 2-year incidence, 0.03%) multivariate analysis of increased risk of endophthalmitis was associated with intraoperative complicati ons, such as posterior capsular rent rent and vitreous loss (relative risk RR, 6.57; 95% confidence interval CI, 1.5-28.5; P = 0.05) for all endophthalmitis cases, age> 60 years for culture positive endophthalmitis cases (RR, 6; 95% CI, 0.7-47.8; P = 0.04), and an extracapsular cataract extraction technique for culture- Had follow-up of 37 days, 5 (29.41%) of the 17 patients achieved a best-corrected visu al acuity (BCVA) of 20/40, and the remaining 7 (32.3%) had a BCVA better than 2 0/200. Of the culture-positive cases, Nocardia species was the most common orga nism isolated, accounting for more than half of these cases (6/10 60%). Conclusions: This study found the incidence of acute postoperative endophthalmitis after cataract surgery to be 0.05%. Extracapsular cataract extraction technique and the occurrence of intraoperative complications are major risk factors for developing endophthalmitis. Visual outcome after endophthalmitis was generally poor. Nocardia is a lesser-known but virulent organism causing endophthalmitis, the management of which still poses a therapeutic dilemma.