Incidence and outcomes evaluation of endophthalmitis management after phacoemulsification and 3-piece silicone intraocular lens implantation over 6 years in a single eye unit.

PURPOSE

To evaluate the incidence and outcomes of management of endophthalmitis following phacoemulsification and 3-piece silicone intraocular lens (IOL) implantation in a single eye unit over a 6-year period.

SETTING

Shrewsbury and Telford Hospital, NHS Trust, Shrewsbury, United Kingdom.

METHODS

Forty-four cases of endophthalmitis following phacoemulsification and 3-piece silicone IOL implantation were identified between January 1, 1998, and December 31, 2003. All the data related to the endophthalmitis cases were prospectively collected. The total number of cataract surgeries was identified from the hospital information technology department through coding data.

RESULTS

There were 44 cases of endophthalmitis following 12 362 phacoemulsification cataract extractions (incidence 0.36%). The incidence of endophthalmitis with a silicone polypropylene IOL (0.67%) was significantly higher (P<.0005) than with a silicone poly(methyl methacrylate) (PMMA) IOL (0.24%). Thirty-six patients (81.8%) had vitreous tap while 8 patients (18.2%) had vitrectomy. Twenty cases (45.5%) were culture positive. Visual acuity was 6/12 or better in 30 patients (68.8%). There was weak correlation between visual acuity at presentation and final visual outcome (Pearson correlation r = 0.33, P = .029). Final visual acuity was not significantly related to culture results (P = .85, Mann-Whitney U test) or type of presentation (P = .52, Mann-Whitney U test).

CONCLUSIONS

In this first single-center study to report incidence of endophthalmitis following phacoemulsification and silicone IOL implantations alone, the incidence of endophthalmitis was significantly higher with silicone polypropylene IOLs than with silicone PMMA IOLs and the overall incidence of endophthalmitis following phacoemulsification surgery was higher than most of the published data.