TY - JOUR
T1 - Endophthalmitis After Clear Corneal Cataract Surgery
T2 - Outcomes Over Two Decades
AU - Yannuzzi, Nicolas A.
AU - Si, Nancy
AU - Relhan, Nidhi
AU - Kuriyan, Ajay E.
AU - Albini, Thomas A.
AU - Berrocal, Audina M.
AU - Davis, Janet L.
AU - Smiddy, William E.
AU - Townsend, Justin
AU - Miller, Darlene
AU - Flynn, Harry W.
N1 - Funding Information:
Funding/Support: This study is supported in part by NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, and Department of Defense (DOD ? Grant #W81XWH-13-1-0048). Financial Disclosures: The following authors have no financial disclosures: Nicolas A. Yannuzzi, Nancy Si, Nidhi Relhan, Ajay E. Kuriyan, Thomas A. Albini, Audina M. Berrocal, Janet L. Davis, William E. Smiddy, Justin Townsend, Darlene Miller, and Harry W. Flynn. All authors attest that they meet the current ICMJE criteria for authorship.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Purpose To report the clinical features, causative organisms, and visual acuity (VA) outcomes associated with acute-onset endophthalmitis after clear corneal cataract surgery over the past 2 decades. Design Retrospective case series. Methods Clinical and microbiology records were reviewed for 63 eyes of 63 patients who presented to a tertiary referral center between 2006 and 2015 with culture-positive endophthalmitis occurring within 6 weeks of clear corneal cataract surgery. Results The mean time between surgery and diagnosis of endophthalmitis was 8 days (median 6 days). The initial treatment included intravitreal vancomycin and ceftazidime in 59 of 63 (94%) eyes and intravitreal vancomycin and amikacin in 4 of 63 (6%) eyes. Intravitreal dexamethasone was used in 50 of 63 (79%) eyes. A vitreous tap and injection with antibiotics was performed as the initial treatment in 57 of 63 (90%) eyes and pars plana vitrectomy in 6 of 63 (10%) eyes. Coagulase-negative Staphylococcus was isolated in 39 of 63 (62%) eyes, Staphylococcus aureus in 7 of 63 (11%) eyes, and Streptococcus species in 7 of 63 (11%) eyes. A VA of ≥20/40 was achieved in 24 of 63 (38%) eyes. None of the gram-positive isolates were vancomycin resistant. Twenty-four of 49 isolates (49%) were sensitive to cephalothin, cefazolin, and cefuroxime. Sensitivity to fluoroquinolones included 22 of 52 (42%) to levofloxacin, 20 of 54 (37%) to ciprofloxacin, 16 of 47 (34%) to moxifloxacin, and 3 of 13 (23%) to gatifloxacin. Conclusion Causative organisms and visual outcomes are similar to those reported in the prior decade. In the current study, a number of isolates were resistant to cephalosporins and fluoroquinolones.
AB - Purpose To report the clinical features, causative organisms, and visual acuity (VA) outcomes associated with acute-onset endophthalmitis after clear corneal cataract surgery over the past 2 decades. Design Retrospective case series. Methods Clinical and microbiology records were reviewed for 63 eyes of 63 patients who presented to a tertiary referral center between 2006 and 2015 with culture-positive endophthalmitis occurring within 6 weeks of clear corneal cataract surgery. Results The mean time between surgery and diagnosis of endophthalmitis was 8 days (median 6 days). The initial treatment included intravitreal vancomycin and ceftazidime in 59 of 63 (94%) eyes and intravitreal vancomycin and amikacin in 4 of 63 (6%) eyes. Intravitreal dexamethasone was used in 50 of 63 (79%) eyes. A vitreous tap and injection with antibiotics was performed as the initial treatment in 57 of 63 (90%) eyes and pars plana vitrectomy in 6 of 63 (10%) eyes. Coagulase-negative Staphylococcus was isolated in 39 of 63 (62%) eyes, Staphylococcus aureus in 7 of 63 (11%) eyes, and Streptococcus species in 7 of 63 (11%) eyes. A VA of ≥20/40 was achieved in 24 of 63 (38%) eyes. None of the gram-positive isolates were vancomycin resistant. Twenty-four of 49 isolates (49%) were sensitive to cephalothin, cefazolin, and cefuroxime. Sensitivity to fluoroquinolones included 22 of 52 (42%) to levofloxacin, 20 of 54 (37%) to ciprofloxacin, 16 of 47 (34%) to moxifloxacin, and 3 of 13 (23%) to gatifloxacin. Conclusion Causative organisms and visual outcomes are similar to those reported in the prior decade. In the current study, a number of isolates were resistant to cephalosporins and fluoroquinolones.
UR - http://www.scopus.com/inward/record.url?scp=85006276875&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85006276875&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2016.11.006
DO - 10.1016/j.ajo.2016.11.006
M3 - Article
C2 - 27889501
AN - SCOPUS:85006276875
VL - 174
SP - 155
EP - 159
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -