Nosocomial postoperative endophthalmitis

Purpose: To evaluate the incidence of postoperative endophthalmitis and assess the visual acuity outcomes after treatment. Methods: We retrospectively reviewed all surgical cases performed over 5 years at our institute for the occurrance of postoperative endophthalmitis. The treatment outcomes are compared to a earlier series performed at the same hospital from 1984 through 1989. Results: A total of 28,622 intraocular surgical procedures and 262 keratorefractive procedures were performed. Acute postoperative endophthalmitis was clinically suspected in 36 cases and culture proven in 30 cases. The incidence of culture proven endophthalmitis was the following: CE ± IOL (0.09%), PPV (0.04%), PK (0.32%), secondary IOL (0.53%), glaucoma (0.16%), combined Trab/CE (0.14%), and combined PK/CE (0%). Average visual acuity outcomes after treatment of culture proven endophthalmitis was the following: CE ± IOL (20/242), PPV (NLP), PK (3/200), secondary IOL (20/35), glaucoma (20/106), and combined Trab/CE (20/326). Conclusions: Compared to the 1984-1989 series, the incidence of postoperative endophthalmitis in the later series is lower for PPV, similar for CE, but higher for all other intraocular procedures. The visual acuity outcomes after management of endophthalmitis were slightly improved in all surgical categories, except PPV.