Researchers recently found that acute-onset endophthalmitis occurs in approximately 0.04% of cataract surgeries performed in the United States, with risk factors including younger age, combined surgeries (cataract with other ophthalmic surgeries) and anterior vitrectomy. They note that while visual acuity outcomes varied, most patients can recover excellent vision after surgery.

This retrospective cohort study evaluated 5.4 million US patients who had cataract surgery between 2013 and 2017. The team identified acute-onset postoperative endophthalmitis cases that occurred within 30 days of surgery and determined annual and aggregate five-year incidences. They compared patient characteristics and pinpointed visual acuities at one month pre-op and one week, one month and three months post-op.

The investigators discovered that 3,629 of the eyes that underwent cataract surgery developed acute-onset endophthalmitis, with the highest incidence falling among patients who were 17 years old or younger, followed by patients between the ages of 18 and 44. They note that endophthalmitis occurred four times more in cases of combined surgical procedures than in standalone cataract surgeries (0.20% vs. 0.04%) and in 0.35% of patients receiving anterior vitrectomy.

They also found that endophthalmitis patients had mean visual acuity of 20/100 three months post-op vs. 20/40 for those without endophthalmitis. However, they add that 4% of endophthalmitis patients still achieved 20/20 or better and 44% achieved 20/40 or better at three months.

Pershing S, Lum F, Hsu S, et al. Endophthalmitis after cataract surgery in the US, a report from the IRIS Registry, 2013-2017. Ophthalmology. August 28, 2019. [Epub ahead of print].