Acute endophthalmitis after cataract surgery: a 10-year review (2003 – 2013)

Aims: Acute endophthalmitis is a potentially sight- threatening complication of cataract surgery. The aim of this study was to evaluate the incidence, microbiology and clinical outcomes of patients with post-cataract surgery endophthalmitis in a public hospital in Hong Kong.Methods: This was a retrospective case series that reviewed patients who underwent cataract surgery and were diagnosed to have acute postoperative endophthalmitis between 1 April 2003 and 31 March 2013 at the Hong Kong Eye Hospital. Main outcome measures were incidence, culture results and visual acuity at the final visit.Results: A total of 31 patients were diagnosed with acute postoperative endophthalmitis out of 46,564 cataract surgeries performed over 10 years. The mean annual incidence rate was 0.067%. A positive culture was found in 72.4% of the intraocular samples. The yield of anterior chamber and vitreous tapping was 39.3% and 57.1%, respectively. Over 95% of isolates were Gram- positive organisms and the most common pathogen was coagulase-negative staphylococcus. At the last follow-up (mean, 28.4 months; range, 2.1-86.3 months), over two-thirds of the patients achieved a visual acuity of 0.3 or more. Presenting visual acuity was positively associated with final visual outcome (p < 0.05).Conclusions: The results of this 10-year review may serve as a reference for local data on acute endophthalmitis after cataract surgery for other centres and future studies.