Jiang Xiaodan, Wan Yu, Yuan Hao, Zhao Liming, Sun Min, Xu Yanhui, Xin Xiangyang, Dong Jing, Hu Die, Chen Dongmei, Li Xuemin
Department of Ophthalmology, Peking University Third Hospital, Beijing, People's Republic of China.
Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, People's Republic of China.
Infect Drug Resist. 2022 Jul 27;15:4047-4058. doi: 10.2147/IDR.S332997. eCollection 2022.
To investigate the incidence of acute postoperative endophthalmitis (POE) after cataract surgery in Northern China from 2013 to 2019, evaluate the efficacy of prophylaxis and analyze the predictors of visual prognosis among POE patients.
The study was conducted as a retrospective multi-center research, with seven hospitals in Northern China enrolled. The diagnosis of acute-onset POE was made on the basis of clinical manifestations within six weeks after initial surgery. By reviewing electronic medical system, the number of cataract surgeries and acute POE cases were recorded to estimate the overall incidence and incidences by different years and hospitals. Perioperative measures for preventing infection in different hospitals were collected. The correlations between unfavorable final vision and potential factors including basic information and clinical characteristics were examined to determine the predictive factors for final visual prognosis.
Of 72,255 cataract surgeries performed during seven years in the seven hospitals, 19 cases developed acute POE, yielding an overall incidence of 0.026%. The average incidence of acute POE among seven hospitals significantly declined annually during the past 7 years (p = 0.021). In Hospital-D, the incidence of acute POE significantly decreased after the application of 0.5% povidone-iodine (PVP-I) for conjunctival washing (p = 0.003). Two hospitals adopting tobramycin in the irrigation solution achieved a significant lower incidence of POE than the other hospitals (p = 0.044). The positive rate of pathogen culture was just 17.6% (3/19). Patients with presenting BCVA of CF or better were more likely to present with unfavorable final vision than those with worse presenting BCVA (p = 0.003).
The overall incidence of acute POE after cataract surgery from 2013 to 2019 in Northern China was 0.026%, and the incidence declined annually over the period. Presenting BCVA could be a significant prognosis factor for predicting the final visual outcomes of acute POE patients.
调查2013年至2019年华北地区白内障手术后急性术后眼内炎（POE）的发生率，评估预防措施的效果，并分析POE患者视觉预后的预测因素。
本研究为回顾性多中心研究，纳入了华北地区的7家医院。急性发作性POE的诊断基于初次手术后6周内的临床表现。通过查阅电子医疗系统，记录白内障手术数量和急性POE病例数，以估计总体发生率以及不同年份和医院的发生率。收集不同医院预防感染的围手术期措施。检查包括基本信息和临床特征在内的潜在因素与不良最终视力之间的相关性，以确定最终视觉预后的预测因素。
在这7家医院7年期间进行的72255例白内障手术中，有19例发生急性POE，总体发生率为0.026%。在过去7年中，7家医院急性POE的平均发生率每年显著下降（p = 0.021）。在D医院，应用0.5%聚维酮碘（PVP-I）进行结膜冲洗后，急性POE的发生率显著降低（p = 0.003）。两家在冲洗液中采用妥布霉素的医院POE发生率明显低于其他医院（p = 0.044）。病原体培养阳性率仅为17.6%（3/19）。初始最佳矫正视力（BCVA）为CF或更好的患者比初始BCVA较差的患者更有可能出现不良最终视力（p = 0.003）。
2013年至2019年华北地区白内障手术后急性POE的总体发生率为0.026%，且在此期间发生率逐年下降。初始BCVA可能是预测急性POE患者最终视觉结果的重要预后因素。
