This article is more than 5 years old. Information may no longer be current.
Increasing rate of endophthalmitis seen in cataract patients
Click Here to Manage Email Alerts
Endophthalmitis rates after cataract surgery increased in the Medicare population in the United States between 1994 and 2001, according to a large-scale study. The incidence climbed from 1.79 cases per 1,000 in 1994 to 2.47 cases per 1,000 in 2001, a 37% increase during the time period, the study authors noted.
Emily S. West, PhD, and colleagues reviewed Medicare 5% beneficiary claims data for inpatient and outpatient claims from 1994 though 2001. All cataract surgery and presumed endophthalmitis cases after cataract surgery were identified based on claims submitted, they said. The annual rate of presumed endophthalmitis after cataract surgery was calculated, and demographic risk factors for endophthalmitis were examined. The main outcome was the incidence rate of endophthalmitis after cataract surgery and the prevalence of demographic risk factors for endophthalmitis over an 8-year period.
There were 1,026 cases of presumed endophthalmitis that occurred after 477,627 cataract surgeries during the time frame of the study, yielding an incidence rate of 2.15 per 1,000 surgeries.
Toward the end of the study period (1998 to 2002), the rates of endophthalmitis, after being adjusted for age, gender and race, were significantly higher than they had been in the earlier part of the study. The age of the Medicare enrollee and being a member of the black race also were associated with an increased risk of endophthalmitis.
The authors noted that because of the lag in Medicare data, they “cannot comment on whether the endophthalmitis rate after cataract surgery has since stabilized or continued to increase.” They further speculated that the use of clear corneal incisions may increase the potential for pathogens to enter the eye. Smaller studies in the United States have also shown a higher rate of endophthalmitis in patients who underwent clear corneal incisions vs. those who underwent scleral tunnel incisions.
“The authors believe that the findings of this study highlight the need for additional research on risk factors for endophthalmitis after cataract surgery based on large representative populations,” they wrote in the August issue of Ophthalmology.