Sabherwal Shalinder, Chaku Deepali, Mathur Umang, Sangwan Virender S, Majumdar Atanu, Gandhi Arpan, Dubey Suneeta, Sood Ishaana
Department of Community Ophthalmology and Public Health Research, Dr. Shroff's Charity Eye Hospital, New Delhi, India.
Executive Medical Director and Head Cornea and Anterior Segment Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India.
Indian J Ophthalmol. 2020 Jun;68(6):1120-1125. doi: 10.4103/ijo.IJO_1493_19.
To compare the five-year incidence of acute post-operative endophthalmitis following cataract surgery, between centers with and without laminar air flow and high-efficiency particulate air (HEPA) filters in operating rooms.
Retrospective analysis of medical records of patients operated in a single network of a tertiary and four secondary hospitals across north India. Cases of endophthalmitis were identified from the records between January 2013 and June 2018. Protocols and consumables were standardized across all hospitals. The only infrastructural difference being the presence of laminar air flow and high energy particulate air filters in operating rooms of the tertiary center. The type of surgery, along with the demographic and socio-economic details, were captured and analyzed, using z-test for proportions and logistic regression.
Out of 88,297 cataract surgeries conducted, 36 cases of endophthalmitis were reported. The incidence of endophthalmitis across the network was estimated to be 0.041%, (95% CI: 0.027 to 0.054). There was no statistically significant difference between the incidence of POE at the tertiary (0.042%) and secondary centers (0.039%). Certain risk factors for high endophthalmitis incidence were identified, namely patients undergoing small incision cataract surgery and belonging to lower socio-economic status. However, for both factors the difference was not statistically significant.
The five-year incidence of acute post-operative endophthalmitis in our network was found comparable to the best reported in literature. Incidence at secondary centers, without laminar air flow and high energy particulate air filters was found comparable to that in the tertiary center having these facilities.
比较在手术室配备与未配备层流空气和高效空气过滤器（HEPA）的中心之间，白内障手术后急性术后眼内炎的五年发病率。
对印度北部一家三级医院和四家二级医院组成的单一网络中接受手术的患者医疗记录进行回顾性分析。从2013年1月至2018年6月的记录中识别眼内炎病例。所有医院的方案和耗材均标准化。唯一的基础设施差异是三级中心手术室存在层流空气和高效空气过滤器。使用比例z检验和逻辑回归分析手术类型以及人口统计学和社会经济细节。
在88297例白内障手术中，报告了36例眼内炎病例。整个网络的眼内炎发病率估计为0.041%，（95%可信区间：0.027至0.054）。三级中心（0.042%）和二级中心（0.039%）的术后眼内炎发病率之间无统计学显著差异。确定了眼内炎高发病率的某些危险因素，即接受小切口白内障手术且社会经济地位较低的患者。然而，对于这两个因素，差异均无统计学显著性。
我们网络中急性术后眼内炎的五年发病率与文献中报道的最佳发病率相当。未配备层流空气和高效空气过滤器的二级中心的发病率与拥有这些设施的三级中心相当。
