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Postoperative endophthalmitis after corneal transplant or cataract surgery is rare, although rates are slightly higher after corneal transplant, according to a claims-based study.
The retrospective population-based cohort study based on Medicare claims data included patients who underwent corneal transplants (18,083), cataract surgeries (2,261,779) or both on the same day (3,705) from July 1, 2006, to Aug. 31, 2011.
Endophthalmitis rates were analyzed at intervals of 6 weeks and 6 months after surgery using a sensitive definition based on ICD-9 codes, a specific definition based on ICD-9 and CPT-4 codes, and a fungal definition based on ICD-9 codes and claims for antifungal medication.
The corneal transplant cohort had the highest incidence of endophthalmitis in all definitions.
Rates of sensitive endophthalmitis were more than three times higher in the corneal transplant group than in the cataract surgery group at 6 weeks and more than five times higher at 6 months; for specific endophthalmitis, rates were twice as high at 6 weeks and four times as high at 6 months.
Rates of fungal endophthalmitis infection were also higher than in the cataract surgery cohort.
Male sex, socioeconomic status and immunosuppressant use correlated with higher risk for endophthalmitis after index surgeries.
Disclosure: The authors have no relevant financial disclosures.
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