Delayed-versus acute-onset endophthalmitis after cataract surgery

Anita R. Shirodkar, Avinash Pathengay, Harry W. Flynn, Thomas A. Albini, Audina M. Berrocal, Janet L. Davis, Geeta A. Lalwani, Timothy G. Murray, William E. Smiddy, Darlene Miller

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


• Purpose: To report a large consecutive case series of patients who developed delayed-onset and acute-onset endophthalmitis after cataract surgery. • Design: Retrospective consecutive case series. • Methods: The current study is a retrospective consecutive case series of patients treated between January 2000 and December 2009 for culture-proven endophthalmitis after cataract surgery. The study defined 2 groups after cataract surgery: acute-onset endophthalmitis (≤6 weeks after surgery) and delayed-onset endophthalmitis (>6 weeks after surgery). • Results: A total of 118 patients met study criteria; cases included 26 delayed-onset cases and 92 acute-onset cases. The following clinical features and outcomes occurred in delayed- vs acute-onset cases: 1) the presenting visual acuity was ≤5/200 in 31% vs 89%; 2) hypopyon was found in 46% vs 80%; 3) the most frequent isolate was Propionibacterium acnes (11/26) vs coagulase-negative Staphylococcus (57/92); and 4) patients with the most frequent isolate achieved a visual outcome of ≥20/100 in 91% vs 56%. In delayed-onset cases, the intraocular lens was removed or exchanged in 19 of 26 cases (73%). Of these 19 cases, 13 achieved a visual outcome of ≥20/100. • Conclusions: Patients with delayed-onset endophthalmitis generally presented with better initial visual acuities, had a lower frequency of hypopyon, and had better visual outcomes compared to acute-onset patients. Propionibacterium acnes and coagulase-negative Staphylococcus species were the most common organisms cultured in delayed- and acute-onset categories, respectively, and were associated with the best visual acuity outcomes in each group.

Original languageEnglish (US)
Pages (from-to)391-398.e2
JournalAmerican journal of ophthalmology
Issue number3
StatePublished - Mar 2012

ASJC Scopus subject areas

  • Ophthalmology


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