Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Ophthalmology. 2022 Mar;129(3):250-257. doi: 10.1016/j.ophtha.2021.09.004. Epub 2021 Sep 17.
To determine national incidence and risk factors associated with developing endophthalmitis after cataract surgery in the United States.
Retrospective, cross-sectional analysis.
Medicare beneficiaries aged ≥65 years undergoing cataract surgery between 2011 and 2019.
Medicare claims were used to identify all patients who underwent ≥1 cataract surgery between 2011 and 2019. Endophthalmitis cases within 90 days of the cataract surgery were identified using diagnostic codes. Patients with a history of endophthalmitis 12 months before their cataract surgery procedure were excluded. Annual and aggregate 9-year incidences were determined for all cataract surgeries and for stand-alone cataract procedures. A stepwise multivariable logistic regression model using generalized estimating equations was used to evaluate factors associated with occurrence of postoperative endophthalmitis.
The 90-day postoperative endophthalmitis rate and patient risk factors associated with onset of endophthalmitis after cataract surgery.
A total of 14 396 438 cataract surgeries were performed among Medicare beneficiaries between 2011 and 2019. The overall 90-day postoperative endophthalmitis rate was 1.36 per 1000 cataract surgeries for all cataract procedures and 1.30 per 1000 cataract surgeries for stand-alone cataract procedures. A decreasing trend was noted for postoperative endophthalmitis rates during the 9-year study period. On multivariable analysis, the risk of endophthalmitis after cataract surgery was increased for cases performed among those aged ≥75 years versus those aged <75 years (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.11-1.18), Blacks (OR, 1.13; 95% CI, 1.07-1.20), Native Americans (OR, 1.43; 95% CI, 1.19-1.73), and eyes with any history of invasive glaucoma surgery (OR, 1.40; 95% CI, 1.18-1.65). Cataract cases combined with retinal surgery (OR, 2.60; 95% CI, 2.15-3.16) and those performed when the Charlson Comorbidity Index (CCI) was greater than 0 also had an increased likelihood of developing endophthalmitis. The risk of endophthalmitis was lower for cases performed on women versus men (OR, 0.89; 95% CI, 0.86-0.92).
The overall 90-day postoperative endophthalmitis rate after cataract surgery was 1.36 per 1000 cataract surgeries between 2011 and 2019. Patient age, gender, race, and CCI were associated with risk of endophthalmitis.
在美国确定白内障手术后发生眼内炎的全国发病率和相关风险因素。
回顾性、横断面分析。
2011 年至 2019 年间接受白内障手术且年龄≥65 岁的医疗保险受益人群。
使用医疗保险索赔确定 2011 年至 2019 年间至少进行过一次白内障手术的所有患者。在白内障手术后 90 天内使用诊断代码确定眼内炎病例。排除白内障手术前 12 个月有眼内炎病史的患者。确定所有白内障手术和单独白内障手术的年度和累计 9 年发病率。使用广义估计方程的逐步多变量逻辑回归模型评估与白内障手术后发生眼内炎相关的因素。
白内障手术后 90 天的眼内炎发生率以及与白内障手术后发生眼内炎相关的患者风险因素。
在 2011 年至 2019 年期间，共有 14396438 例白内障手术在医疗保险受益人群中进行。所有白内障手术的术后 90 天眼内炎总发生率为每 1000 例白内障手术 1.36 例，单独白内障手术的发生率为每 1000 例白内障手术 1.30 例。在 9 年的研究期间，术后眼内炎发生率呈下降趋势。多变量分析显示，与<75 岁的患者相比，≥75 岁的患者（比值比 [OR]，1.14；95%置信区间 [CI]，1.11-1.18）、黑人（OR，1.13；95%CI，1.07-1.20）、美国原住民（OR，1.43；95%CI，1.19-1.73）以及任何有过侵袭性青光眼手术史的眼睛（OR，1.40；95%CI，1.18-1.65）发生眼内炎的风险更高。白内障合并视网膜手术（OR，2.60；95%CI，2.15-3.16）和Charlson 合并症指数（CCI）>0 时进行的白内障手术发生眼内炎的可能性也增加。与男性相比，女性（OR，0.89；95%CI，0.86-0.92）发生眼内炎的风险较低。
2011 年至 2019 年间，白内障手术后 90 天的总体眼内炎发生率为每 1000 例白内障手术 1.36 例。患者年龄、性别、种族和 CCI 与眼内炎风险相关。
