Epidemiology of Acute Endophthalmitis After Cataract Surgery in Mexican Hospital for 5- Year Period: Incidence and Outcome

Friday, April 25, 2014
KIOSKS (Boston Convention and Exhibition Center)
Cynthia Villalobos-Ojeda, MD, Asociacion para evitar la ceguera en mexico, México D.F., Mexico
Susana M. Peniche, MD mexico, Mexico
Lourdes Fernandez mexico, Mexico

Narrative Responses:

Purpose
To investigate the epidemiology of postoperative endophthalmitis after cataract surgery in a mexican hospital  for a period of five years

Methods
Retrospective , observational case series. The clinical and microbiological records of all patients with a clinical diagnosis of endophthalmitis within 6 weeks after cataract surgery, regardless of the technique (phacoemulsification or extracapsular extraction) in a period between January 2005 and April 2011 were reviewed. Main outcome measures: Incidence, surgical technique, intraoperative complications, treatment, microorganisms found and final visual acuity.

Results
The incidence of postoperative endophthalmitis was 0.06% (15/24601) (95% CI 0.0030-0.0028), 0.04% phacoemulsification, 0.16% extracapsular extraction. Eight (53.33%) had complications; seven posterior capsule rupture, one zonular dialysis. Fifteen patients received intravitreal and topical antibiotics, six  (40%) posterior vitrectomy. The microorganisms isolated from aqueous and vitreous  were Gram-positive. The resistance to antibiotics was 31.20% vancomycin, 30% ceftazidime, 15.30% moxifloxacin, 7.40% gatifloxacin. After a median follow-up of 120 days, best-corrected visual acuity was less than 1.00logmar in 62.5% and more than 0.4logmar in 20%. A predictor of  final visual acuity  better than 0.4 was baseline acuity of counting fingers or better (OR 0.05)

Conclusion
Endophthalmitis is a devastating complication. The reported incidence is 0.06% - 0.32%. The incidence on our hospital is 0.06% as reported. Is important to consider the resistance found in our study to the most commonly used antibiotics,in order to consider the use of a different antibiotic.