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Cataract surgery with topical anesthesia associated with higher endophthalmitis rates
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Performing cataract surgery using topical anesthesia may be associated with an increased incidence of endophthalmitis, according to a study by researchers in Spain.
Jose Garcia-Arumi, MD, and colleagues in Barcelona reviewed records for all patients clinically diagnosed with endophthalmitis within 30 days after undergoing cataract surgery between February 2002 and September 2003. Investigators then compared all endophthalmitis cases with 108 randomly selected control cases.
Surgeons performed 5,011 cataract extractions during the study period. Of these, 27 cases developed endophthalmitis, for an incidence of 5.39 cases per 1,000 cataract surgeries, according to the study.
The researchers found an independent, statistically significant relationship between endophthalmitis and the use of topical anesthesia as well as with surgery lasting longer than 45 minutes. Retrobulbar anesthesia was associated with an endophthalmitis incidence of 1.8 per 1,000 cataract surgeries, while topical anesthesia was associated with an incidence of 6.76 cases per 1,000 surgeries, according to the study.
"After the start of the study period was extended to May 2001, the incidence of endophthalmitis was 1.3 per 1,000 cataract extractions with retrobulbar anesthesia and 8.7 per 1,000 with topical anesthesia," the authors reported.
The study is published in the June issue of Journal of Cataract and Refractive Surgery.